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Multimodality management for chronic subdural hematoma in China: protocol and characteristics of an ambidirectional,
Tao Liu1,2, Zhihao Zhao1,2, Jinhao Huang1,2
1Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
Insights
This study on chronic subdural hematoma (CSDH) management in China found that most patients achieved favorable outcomes with multimodality treatments, showing a low recurrence rate. This provides valuable insights for improving CSDH patient care.
Area of Science:
- Neurosurgery
- Epidemiology
- Clinical Research
Background:
- Chronic subdural hematoma (CSDH) management strategies are debated due to varied presentations and outcomes.
- A nationwide registry study was conducted to evaluate multimodality treatment efficacy and safety in Chinese CSDH patients.
Purpose of the Study:
- To assess the efficacy and safety of various treatment approaches for chronic subdural hematoma (CSDH).
- To provide insights into the management of CSDH within the Chinese population.
Main Methods:
- An ambidirectional, nationwide, multicenter registry study involving 59 hospitals in mainland China.
- Documentation of patient demographics, clinical characteristics, radiographic findings, and surgical techniques.
- Assessment of clinical outcomes including hematoma resolution, recurrence, neurological status, and complications over 2 years.
Main Results:
- A cohort of 2173 CSDH patients (81.1% male, mean age 70.12 years) was analyzed.
- Headache was the most common symptom (58.1%), with trauma history in 48.0%.
- Burr hole surgery (61.3%) was the primary intervention; 88.9% showed favorable outcomes at 3 months with a 2.4% recurrence rate.
Conclusions:
- Multimodality treatment for CSDH in China demonstrates favorable outcomes and low recurrence rates.
- Findings offer a foundation for optimizing clinical practices and patient management for CSDH.
- This research aims to improve the quality of life for individuals with this neurosurgical condition.
Background:
Despite its prevalence, there is ongoing debate regarding the optimal management strategy for chronic subdural hematoma (CSDH), reflecting the variability in clinical presentation and treatment outcomes. This ambidirectional, nationwide, multicenter registry study aims to assess the efficacy and safety of multimodality treatment approaches for CSDH in the Chinese population.
Methods/Design:
A multicenter cohort of CSDH patients from 59 participating hospitals in mainland China was enrolled in this study. The treatment modalities encompassed a range of options and baseline demographics, clinical characteristics, radiographic findings, and surgical techniques were documented. Clinical outcomes, including hematoma resolution, recurrence rates, neurological status, and complications, were assessed at regular intervals during treatment, 3 months, 6 months, 1 year, and 2 years follow-up.
Result:
Between March 2022 and August 2023, a comprehensive cohort comprising 2173 individuals who met the criterion was assembled across 59 participating clinical sites. Of those patients, 81.1% were male, exhibiting an average age of 70.12 ± 14.53 years. A historical record of trauma was documented in 48.0% of cases, while headache constituted the predominant clinical presentation in 58.1% of patients. The foremost surgical modality employed was the burr hole (61.3%), with conservative management accounting for 25.6% of cases. Notably, a favorable clinical prognosis was observed in 88.9% of CSDH patients at 3 months, and the recurrence rate was found to be 2.4%.
Conclusion:
This registry study provides critical insights into the multimodality treatment of CSDH in China, offering a foundation for advancing clinical practices, optimizing patient management, and ultimately, improving the quality of life for individuals suffering from this challenging neurosurgical condition.
Trial Registration:
ChiCTR2200057179.
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