The relationship between serum coagulation parameters and the recurrence of chronic subdural hematoma

Area of Science:

• Neurology
• Hematology
• Medical Diagnostics

Background:

• Chronic subdural hematoma (CSH) is a common neurosurgical condition.
• Recurrence of CSH poses significant challenges in patient management.
• Predictive markers for CSH recurrence are crucial for optimizing treatment strategies.

Purpose of the Study:

• To investigate the association between pre-hospitalization serum coagulation parameters and CSH recurrence.
• To identify novel predictors for CSH recurrence, particularly early post-operative relapse.
• To evaluate the combined predictive value of D-dimer (D-D) and fibrin/fibrinogen degradation products (FDP).

Main Methods:

• Retrospective analysis of 236 first-time CSH patients with complete medical records.
• Follow-up for at least 90 days to assess recurrence rates.
• Univariate analysis of general, imaging, and laboratory data, including PT, APTT, D-D, and FDP levels.

Main Results:

• CSH recurrence was observed in 21.2% of patients.
• Significant recurrence predictors included advanced age, hypertension, liver disease, anticoagulant/antiplatelet use, bilateral, and single-layer hematomas.
• Elevated FDP (>5 mg/L) and combined elevated D-D and FDP levels were significantly associated with CSH recurrence, especially within 30 days post-surgery.

Conclusions:

• Serum FDP and D-D levels upon admission are potential novel predictors for CSH recurrence.
• Simultaneous elevation of FDP and D-D may indicate a higher risk of early post-operative recurrence.
• Older CSH patients undergoing surgery require close monitoring due to higher recurrence rates.