Nomogram-Based Independent Risk Factor Analysis and Recurrence Prediction for Chronic Subdural Hematoma After Single...

AIM: To identify independent risk factors and propose a predictor scoring system in chronic subdural hematoma (CSDH). MATERIAL and METHODS: Through retrospective analysis, we analyzed the data from 279 patients with CSDH from 2010 to 2020. Independent risk factors for recurrence were identified through univariate and logistic regression analyses. A risk-scoring model was developed using a nomogram, which was applied to all patients considering postoperative recurrence as a target. ROC curve analysis was done to assess the accuracy of the estimated scoring system. RESULTS: The results revealed significant differences in Glasgow outcome scale (GOS), brain re-expansion after drainage, postoperative use of atorvastatin, side and density of hematoma, the history of trauma, hematoma separated, History of diabetes, and midline shift between patients with recurrent CSDH and non-recurrent. A scoring parameter was developed through a nomogram based on a combination of scored risk factors that were significantly higher in patients with recurrent CSDH (P-value <0.001). The sensitivity and specificity of the predictor score confirmed its efficacy in predicting the recurrence risk of CSDH (sensitivity: 70.5%, specificity: 45.9 %; cutoff: 0.74 and 95% confidence interval: 6.57-0.74). CONCLUSION: A scoring system was finally obtained for the prediction of postoperative recurrence risk. The establishment of a predictor scoring system will help clinicians better monitor and adopt efficient management strategies for high-risk patients.