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Volumen de drenaje, tiempo de drenaje y volumen de irrigación en el hematoma subdural crónico
Oula Knuutinen1,2,3, Pihla Tommiska4, Christoph Schwartz5
1Department of Neurosurgery, Neurocenter, Oulu University Hospital, Oulu, Finland.
Neurosurgery
|December 12, 2025
Resumen
Un mayor volumen de drenaje y un menor tiempo de drenaje después de la cirugía de hematoma subdural crónico aumentan el riesgo de reoperación. La optimización del drenaje implica considerar el volumen, no solo la duración, para mejorar los resultados del paciente.
Área de la Ciencia:
- Neurosurgery
- Surgical Outcomes
- Clinical Research
Sus antecedentes:
- Postoperative drainage and irrigation benefit chronic subdural hematoma (CSH) surgery.
- The relationship between clinical outcomes and drainage parameters (volume, time) and irrigation volume remains unclear.
Objetivo del estudio:
- To investigate the association between postoperative drainage volume, drainage time, irrigation volume, and clinical outcomes in CSH surgery.
- To clarify the impact of these factors on reoperation rates and functional outcomes.
Principales métodos:
- Post hoc analysis of the multicenter, randomized FINISH trial (2020-2022).
- Logistic regression used to analyze drainage volume, time, and irrigation volume.
- Primary outcome: reoperation rate
- Secondary outcomes: 6-month modified Rankin Scale, adverse events, hematoma width, midline shift.
Principales resultados:
- 546 patients analyzed; 15.4% required reoperation.
- Increased drainage volume correlated with higher reoperation rates (OR 1.15 per 100 mL).
- Longer drainage times correlated with lower reoperation rates (OR 0.98).
- Irrigation volume showed no association with reoperation.
Conclusiones:
- Larger drainage volume and shorter drainage time are linked to increased risk of CSH recurrence.
- Optimal postoperative drainage strategies for CSH may need to incorporate drainage volume alongside duration.
- Current standard drain times may not be universally applicable.
