Long-term health outcomes in survivors after chronic subdural haematoma

Moffatt, Claire E.; Hennessy, Maria; Marshman, Laurence A.G.; Manickam, Appukutty

doi:10.1016/j.jocn.2019.04.039

Cited by 15 publications

(14 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Though given far less attention in the literature given its unclear clinical correlations, characterizing hematoma resolution may provide insight into insidious, longer-term functional and cognitive sequelae of CSDH. In the first study of long-term CSDH outcomes, patients who had undergone surgical evacuation were found to demonstrate poorer long-term functional, cognitive, and mental health outcomes when compared to matched controls, in addition to decreased long-term survival ( 16 ). CSDH survivors with dementia have also been reported to experience greater rates of brain volume loss than those without dementia, suggesting that CSDH may be accelerating the effect of brain atrophy in that population ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Predicting Chronic Subdural Hematoma Resolution and Time to Resolution Following Surgical Evacuation

et al. 2020

View full text Add to dashboard Cite

Background: Growing evidence suggests that chronic subdural hematoma (CSDH) may have long-term adverse effects even after surgical evacuation. Hematoma recurrence is commonly reported as a short-term, postoperative outcome measure for CSDH, but other measures such as hematoma resolution may provide better insight regarding mechanisms behind longer-term sequelae. This study aims to characterize postoperative resolution times and identify predictors for this relatively unexplored metric. Methods: Consecutive cases ( N = 122) of burr hole evacuation for CSDH by a single neurosurgeon at Columbia University Irving Medical Center from 2000 to 2019 were retrospectively identified. Patient characteristics, presenting factors, and date of hematoma resolution were abstracted from the electronic health record. Outcome measures included CSDH resolution at 6 months, surgery-to-resolution time, and inpatient mortality. Univariate and multivariate analyses were performed to determine predictors of outcome measures. Results: Hematoma resolution at 6 months was observed in 58 patients (47.5%), and median surgery-to-resolution time was 161 days (IQR: 85–367). Heavy drinking was predictive of non-resolution at 6 months and longer surgery-to-resolution time, while increased age was predictive of non-resolution at 6 months. Antiplatelet agent resumption was associated with non-resolution at 6 months and longer surgery-to-resolution time on univariate analysis but was not significant on multivariate analysis. Conclusion: Postoperative resolution times for most CSDHs are on the order of several months to a year, and delayed resolution is linked to heavy drinking and advanced age. Subsequent prospective studies are needed to directly assess the utility of hematoma resolution as a potential metric for long-term functional and cognitive outcomes of CSDH.

show abstract

Section: Discussionmentioning

confidence: 99%

Predicting Chronic Subdural Hematoma Resolution and Time to Resolution Following Surgical Evacuation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In this study, more than half of the stroke patients were unable to participate in face-to-face cognitive tests because of geographical factors. Therefore, in studies of long-term cognitive outcomes, patients would potentially benefit from telephone screening (Moffatt, Hennessy, Marshman, & Manickam, 2019). A recent UK community study firstly explored the feasibility of the NINDS-CSN 5-minute scale for telephone assessment and demonstrated sufficient reliability for cognitive screening 1 year after transient ischemic attack or mild stroke (Pendlebury, Welch, et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of cognitive screening tools under different neuropsychological definitions for poststroke cognitive impairment

et al. 2020

View full text Add to dashboard Cite

Objectives The accuracy of cognitive screening tools to detect poststroke cognitive impairment (PSCI) was investigated using various neuropsychological definitions. Methods Hospital‐based stroke patients underwent a comprehensive neuropsychological assessment. The rate of PSCI was estimated using thresholds of 1, 1.5, or 2 standard deviations below the normal control and memory impairment defined by a single or multiple tests. Meanwhile, the diagnostic accuracy of cognitive screening through face‐to‐face assessment using the Mini‐Mental State Examination (MMSE) and the Montreal Cognitive Assessment Scale (MoCA), and telephone assessment using a 5‐minute NINDS‐Canadian Stroke Network (NINDS‐CSN) scale and a six‐item screener (SIS), was both tested under different definitions, with the optimal cutoff selected based on the highest Youden index. Results In stroke patients, the rate of PSCI ranged from 46.3% to 76.3% upon different definitions. The face‐to‐face MoCA was more consistent with the comprehensive cognitive assessment compared to MMSE. The optimal cutoff of PSCI was MMSE ≤ 27 and MoCA ≤ 19. For the telephone tests, the 5‐minute NINDS‐CSN assessment was more reliable, and the optimal cutoff was ≤23, while for SIS ≤ 4. Conclusions Cognitive screening tools including the face‐to‐face MMSE and MoCA, together with the telephone assessment of NINDS‐CSN 5‐minute protocol and SIS, were simple and effective for detecting PSCI in stroke patients. The corresponding threshold values for PSCI were 27 points, 19 points, 23 points, and 4 points.

show abstract

“…Nossos resultados corroboram os dados encontrados na literatura quanto a prevalência de sintomas depressivos em pacientes idosos que sofreram TCE (153) e mais especificamente em idosos acometidos por HSDC (52). Entretanto, faz-se necessário refletir se parte destes sintomas depressivos não poderiam ser prévios ao HSDC posto que a depressão é descrita na literatura como um fator de risco para traumas encefálicos em idosos, pois aumenta de forma significativa a possibilidade de quedas (18) (19).…”

Section: Sintomas De Humor E Funcionalidadeunclassified

“…Foi evidenciado que na fase 1, 27,03% apresentavam dependência funcional, enquanto na fase 2 este número reduz para 13,51%. A prevalência na avaliação tardia de pacientes que apresentam dependência funcional coincide com trabalho prévio, que indica desfecho com 13% dos pacientes apresentando perda de capacidade para executar atividades instrumentais (52).…”

Section: Sintomas De Humor E Funcionalidadeunclassified

“…Pesquisas indicam que as taxas de transtornos de ansiedade entre estes pacientes são de 3-28% para Transtorno de Foi encontrado apenas um trabalho específico aos sintomas de humor em idosos com HSDC, o qual evidenciou que este grupo de pacientes apresentam pior bem-estar emocional, psicológico e social quando comparado com grupo controle de idosos saudáveis. Foi observado que 13,8% dos pacientes apresentavam sintomas indicativos de depressão(52).Idosos deprimidos podem apresentar queixas cognitivas, especialmente de memória episódica, e alguns destes, podem de fato apresentar alterações na avaliação neuropsicológica. Nestes casos os domínios mais comprometidos são: memória episódica, funcionamento executivo e velocidade de processamento das informações(82).…”

unclassified

See 1 more Smart Citation

Estudo prospectivo das alterações neuropsicológicas e prognósticas em pacientes idosos com hematoma subdural crônico

Ribeiro¹

View full text Add to dashboard Cite

Gráfico 2 -Representação gráfica do tipo Boxplot do resultado no escore composto de Funcionamento Executivo do grupo controle, Fase 1 e Fase 2 .. 46 Gráfico 3 -Representação gráfica do tipo Boxplot do resultado no escore composto de Memória de Longo Prazo do grupo controle, Fase 1 e Fase 2 ... 47 Gráfico 4 -Representação gráfica do tipo Boxplot do resultado no escore composto de Linguagem do grupo controle, Fase 1 e Fase 2..

show abstract

Long-term health outcomes in survivors after chronic subdural haematoma

Cited by 15 publications

References 24 publications

Predicting Chronic Subdural Hematoma Resolution and Time to Resolution Following Surgical Evacuation

Predicting Chronic Subdural Hematoma Resolution and Time to Resolution Following Surgical Evacuation

Diagnostic accuracy of cognitive screening tools under different neuropsychological definitions for poststroke cognitive impairment

Estudo prospectivo das alterações neuropsicológicas e prognósticas em pacientes idosos com hematoma subdural crônico

Contact Info

Product

Resources

About