Mortality and outcome in patients undergoing burr-hole drainage of chronic subdural hematoma above the age of 80 years.

Abstract

OBJECTIVE\nChronic subdural hematoma is frequently seen within the elderly population and neurosurgeons are confronted with patients over 80 years presenting with symptomatic chronic subdural hematoma. However, data on surgical outcome is scarce. The aim of this study is to analyze the mortality and outcome after burr-hole drainage in patients above the age of 80 years.\n\n\nMETHODS\nSingle center retrospective study including patients undergoing burr-hole drainage of chronic subdural hematoma between the years 2016 and 2019. The cohort was divided into three age groups (80-84 years; 85-89 years; >90 years). Primary outcome was 30-day and overall mortality, while secondary outcome measures were recurrence rates, postoperative bleeding rates and outcome measured by the modified ranking scale. Uni- and multivariate analysis was conducted to assess for potential risk factors for mortality, recurrence and postoperative bleeding rates.\n\n\nRESULTS\n107 patients with a mean age of 85.5±3.9 years were included. Mortality rate was under 10% in each group, showing no significant difference between them (p=0.455). No significant difference in recurrence and postoperative bleeding rates were seen (p=0.491 and p=0.532). Modified Ranking scale differed significantly at release, while at follow up no difference was seen. After uni- and multivariate analysis, age was not correlated with higher recurrence, postoperative bleeding, or mortality rates. Preoperative midline shift was found to be an independent risk factor for recurrence.\n\n\nCONCLUSIONS\nIn patients above the age of 80 years undergoing burr-hole drainage for chronic subdural hematoma, age was not directly correlated with higher recurrence, postoperative bleeding, or mortality rates.