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dc.contributor.authorGlancz, Laurence Johann
dc.contributor.authorPoon, Michael Tin Chung
dc.contributor.authorCoulter, Ian Craig
dc.contributor.authorHutchinson, Peter
dc.contributor.authorKolias, Angelos
dc.contributor.authorBrennan, Paul Martin
dc.contributor.authorBritish Neurosurgical Trainee Research Collaborative (BNTRC)
dc.date.accessioned2018-12-18T00:31:05Z
dc.date.available2018-12-18T00:31:05Z
dc.date.issued2019-10-01
dc.identifier.issn0148-396X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/287044
dc.description.abstractBACKGROUND: Drain insertion following chronic subdural hematoma (CSDH) evacuation improves patient outcomes. OBJECTIVE: To examine whether this is influenced by variation in drain location, positioning or duration of placement. METHODS: We performed a subgroup analysis of a previously reported multicenter, prospective cohort study of CSDH patients performed between May 2013 and January 2014. Data were analyzed relating drain location (subdural or subgaleal), position (through a frontal or parietal burr hole), and duration of insertion, to outcomes in patients aged >16 yr undergoing burr-hole drainage of primary CSDH. Primary outcomes comprised modified Rankin scale (mRS) at discharge and symptomatic recurrence requiring redrainage within 60 d. RESULTS: A total of 577 patients were analyzed. The recurrence rate of 6.7% (12/160) in the frontal subdural drain group was comparable to 8.8% (30/343) in the parietal subdural drain group. Only 44/577 (7.6%) patients underwent subgaleal drain insertion. Recurrence rates were comparable between subdural (7.7%; 41/533) and subgaleal (9.1%; 4/44) groups (P = .95). We found no significant differences in discharge mRS between these groups. Recurrence rates were comparable between patients with postoperative drainage for 1 or 2 d, 6.4% and 8.4%, respectively (P = .44). There was no significant difference in mRS scores between these 2 groups (P = .56). CONCLUSION: Drain insertion after CSDH drainage is important, but position (subgaleal or subdural) and duration did not appear to influence recurrence rate or clinical outcomes. Similarly, drain location did not influence recurrence rate nor outcomes where both parietal and frontal burr holes were made. Further prospective cohort studies or randomized controlled trials could provide further clarification.
dc.format.mediumPrint
dc.languageeng
dc.publisherOvid Technologies (Wolters Kluwer Health)
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectBritish Neurosurgical Trainee Research Collaborative (BNTRC)
dc.subjectHumans
dc.subjectHematoma, Subdural, Chronic
dc.subjectRecurrence
dc.subjectTreatment Outcome
dc.subjectDrainage
dc.subjectTrephining
dc.subjectPostoperative Period
dc.subjectProspective Studies
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectMulticenter Studies as Topic
dc.subjectUnited Kingdom
dc.titleDoes Drain Position and Duration Influence Outcomes in Patients Undergoing Burr-Hole Evacuation of Chronic Subdural Hematoma? Lessons from a UK Multicenter Prospective Cohort Study.
dc.typeArticle
prism.endingPage493
prism.issueIdentifier4
prism.publicationDate2019
prism.publicationNameNeurosurgery
prism.startingPage486
prism.volume85
dc.identifier.doi10.17863/CAM.34354
dcterms.dateAccepted2018-07-14
rioxxterms.versionofrecord10.1093/neuros/nyy366
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-10
dc.contributor.orcidHutchinson, Peter [0000-0002-2796-1835]
dc.contributor.orcidKolias, Angelos [0000-0003-3992-0587]
dc.identifier.eissn1524-4040
rioxxterms.typeJournal Article/Review
pubs.funder-project-idEuropean Commission (602150)
pubs.funder-project-idMedical Research Council (G0601025)
pubs.funder-project-idMedical Research Council (G1002277)
pubs.funder-project-idMedical Research Council (G0600986)
pubs.funder-project-idMedical Research Council (G9439390)
pubs.funder-project-idNETSCC (None)
pubs.funder-project-idNETSCC (None)
pubs.funder-project-idTCC (None)
cam.issuedOnline2019-10


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International