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Presenting symptoms and functional outcome of chronic subdural hematoma patients
Author(s) -
Blaauw Jurre,
Meelis Ghislaine A.,
Jacobs Bram,
Gaag Niels A.,
Jellema Korné,
Kho Kuan H.,
Groen Rob J.M.,
Naalt Joukje,
Lingsma Hester F.,
den Hertog Heleen M.
Publication year - 2022
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.13518
Subject(s) - glasgow coma scale , glasgow outcome scale , medicine , confounding , pediatrics , ordinal regression , cognition , outcome (game theory) , physical therapy , psychiatry , statistics , mathematics , mathematical economics
Abstract Background Patients with chronic subdural hematoma (CSDH) can present with a variety of signs and symptoms. The relationship of these signs and symptoms with functional outcome is unknown. Knowledge of these associations might aid clinicians in the choice to initiate treatment and may allow them to better inform patients on expected outcomes. Objective To investigate if presenting signs and symptoms influence functional outcome in patients with CSDH. Methods We conducted a retrospective analysis of consecutive CSDH patients in three hospitals. Glasgow Outcome Scale Extended (GOS‐E) scores were obtained from the first follow‐up visit after treatment. An ordinal multivariable regression analysis was performed, to assess the relationship between the different signs and symptoms on the one hand and functional outcome on the other adjusted for potential confounders. Results We included 1,307 patients, of whom 958 (73%) were male and mean age was 74 (SD ± 11) years. Cognitive complaints were associated with lower GOS‐E scores at follow‐up (aOR 0.7, 95% CI: 0.5 – 0.8) Headache and higher Glasgow Coma Scale (GCS) scores were associated with higher GOS‐E scores. (aOR 1.9, 95% CI: 1.5–2.3 and aOR 1.3, 95% CI: 1.2–1.4). Conclusion Cognitive complaints are independently associated with worse functional outcome, whereas headache and higher GCS scores are associated with better outcome. The increased probability of unfavorable outcome in patients with CSDH who present with cognitive complaints favors a more prominent place of assessing cognitive status at diagnosis.