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Hematologic Indices and Chronic Subdural Hematoma: A Single-Center Cohort Study
Hrvoje Barić1,2, Sara Komljenović3, Katarina Bilić3
1Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia.
Asian Journal of Neurosurgery
|November 28, 2024
Summary
Hematologic and inflammatory markers like red cell distribution width (RDW), systemic immune-inflammatory index (SII), and platelet-to-lymphocyte ratio (PLR) show prognostic potential in chronic subdural hematoma (cSDH) management. These markers can aid in diagnosing and predicting outcomes for cSDH patients.
Area of Science:
- Neurosurgery
- Neurology
- Inflammation Research
Background:
- Chronic subdural hematoma (cSDH) is a prevalent condition, particularly in the elderly, with significant recurrence rates and potential for severe complications.
- Inflammation is recognized as a key factor in cSDH pathogenesis, and laboratory markers have shown utility as prognostic indicators.
- Identifying reliable markers for cSDH management is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the role of hematologic and inflammatory markers in the diagnosis and prognosis of chronic subdural hematoma (cSDH).
- To compare these markers between different cSDH thickness groups to identify potential predictive values.
- To assess the association of these markers with patient outcomes, including Glasgow Outcome Score (GOS), mortality, and recurrence.
Main Methods:
- A retrospective review of 72 patients with cSDH treated between 2018 and 2020 was conducted.
- Data collected included patient demographics, clinical factors (GCS, anticoagulants), laboratory markers (leukocyte, neutrophil, platelet, CRP, hemoglobin, RDW, neutrophil-to-lymphocyte ratio, PLR, SII), cSDH characteristics (size, midline shift), and treatment details.
- Hematologic and inflammatory indices were compared between cSDH groups stratified by thickness (15 mm threshold).
Main Results:
- Patients (median age 77) with cSDH often had comorbidities and received anticoagulant treatment.
- Significant differences in white blood cell count, red cell distribution width (RDW), systemic immune-inflammatory index (SII), and platelet-to-lymphocyte ratio (PLR) were observed between cSDH thickness groups (p < 0.05).
- The study noted a 27.8% recurrence rate and 25% reoperation rate within one year, with 11.1% mortality.
Conclusions:
- Hematologic indices, including RDW, SII, and PLR, demonstrate significant diagnostic and prognostic value in the management of chronic subdural hematoma.
- These laboratory markers may aid clinicians in assessing disease severity and predicting outcomes in cSDH patients.
- Further research into these markers could refine treatment strategies and improve patient care for cSDH.
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