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Importance of frailty evaluation in the prediction of the prognosis of patients with chronic subdural hematoma
Author(s) -
Shimizu Kiyoharu,
Sadatomo Takashi,
Hara Takeshi,
Onishi Shumpei,
Yuki Kiyoshi,
Kurisu Kaoru
Publication year - 2018
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13436
Subject(s) - medicine , modified rankin scale , confidence interval , chronic subdural hematoma , hematoma , logistic regression , glasgow coma scale , surgery , midline shift , ischemia , ischemic stroke
Aim The present study aimed to clarify the relationship between frailty and prognosis of patients with chronic subdural hematoma. Methods This retrospective study involved 211 patients aged ≥65 years with chronic subdural hematoma, who underwent surgery at Higashihiroshima Medical Center, Hiroshima, Japan, between July 2011 and May 2017. The study outcome was the patient's modified Rankin Scale score at 3 months after surgery. A logistic regression analysis was carried out to analyze factors that influenced the outcome. Results Chronic subdural hematoma patients with frailty had a poorer prognosis than those without (median modified Rankin Scale: 4 and 2, P < 0.001; proportions of patients discharged to home: 35% and 91%, P < 0.001, respectively). After adjusting for patients’ background, the patients’ modified Rankin Scale scores at 3 months after surgery were found to be associated with age, controlling nutritional status score and recurrence, but not with frailty. However, receiver operating characteristic curves of the model with the Clinical Frailty Scale were more accurately correlated with prognosis than those of the model without this scale (area under the curve 0.98, 95% confidence interval 0.96–0.99; and 0.87, 95% confidence interval 0.82–0.91, respectively.) Conclusions Chronic subdural hematoma patients with frailty had poorer prognosis than those without. The evaluation of the presence of frailty on admission can be an important factor in the prediction of the prognosis of chronic subdural hematoma patients. Geriatr Gerontol Int 2018; 18: 1173–1176 .