Age-related tolerability of hard-channel puncture and drainage for chronic subdural hematoma: A single-center retrospective study
Related Experiment Video
Updated: Jan 7, 2026
A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
Wen-Yu Cao1, Peng Guo, Jin-Ping Li
1Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Insights
Age is linked to higher mortality and poorer functional recovery in chronic subdural hematoma patients treated with hard-channel therapy. However, age
Area of Science:
- Neurosurgery and Neurology
- Geriatric Medicine
- Medical Technology Assessment
Background:
- Chronic subdural hematoma (CSH) is common in the elderly.
- Hard-channel therapy is a treatment option for CSH.
- Understanding age-related tolerability of hard-channel therapy is crucial, especially for older patients.
Purpose of the Study:
- To evaluate the age-related tolerability of hard-channel therapy for chronic subdural hematoma.
- To assess the association between age and outcomes such as mortality, complications, recurrence, functional recovery, and hospital stay.
Main Methods:
- Retrospective analysis of 191 chronic subdural hematoma patients treated with hard-channel therapy (December 2016 - March 2023).
- Age was analyzed as a continuous variable.
- Outcomes assessed included mortality, surgery-related complications, recurrence, functional outcomes (mRS), and hospital stay length.
Main Results:
- Median patient age was 75 years.
- Age significantly correlated with increased mortality (OR 1.14, P=.020) and poorer functional recovery (β=0.02, P=.009).
- No significant association found between age and complication rates, recurrence, or hospital stay duration.
Conclusions:
- Age is a significant predictor of mortality and functional outcomes in CSH patients undergoing hard-channel therapy.
- The impact of age on outcomes appears to be mediated by comorbidities and pre-existing functional status.
- Risk models for elderly patients should incorporate functional status and comorbidity burden for accurate assessment of hard-channel therapy.
Abstract:
Chronic subdural hematoma predominantly occurs in the elderly population; however, this study includes patients across all age groups. Age was analyzed as a continuous variable to evaluate its effect on the tolerability of hard-channel therapy in elderly patients. We retrospectively analyzed 191 chronic subdural hematoma patients treated with hard-channel therapy from December 2016 to March 2023. Age was treated as a continuous variable to assess its association with mortality, surgery-related complications, recurrence, functional outcomes, and hospital stay length. This study aimed to assess the age-related tolerability of hard-channel therapy for chronic subdural hematoma, focusing particularly on elderly patients. Among 191 patients with chronic subdural hematoma treated by hard-channel therapy, the median age was 75 years. Age was significantly associated with increased mortality (odds ratio 1.14, P = .020) and poorer functional recovery measured by mRS (β = 0.02, P = .009). No significant associations were found between age and complication rates, recurrence, or hospital stay duration. Preoperative Barthel Index independently predicted mortality risk after adjustment. Comorbidity burden was correlated with worse functional outcomes. Age was significantly associated with adverse postoperative outcomes in univariate analysis, but this effect was attenuated after adjustment for functional status and comorbidities. This suggests age mainly reflects cumulative comorbidity and functional impairment. Incorporating these factors into risk models is essential for evaluating elderly patients undergoing hard-channel therapy.
