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Incidence of chronic subdural haematoma: a single-centre exploration of the effects of an ageing population with a review of the literature.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Stubbs, DJ 
Vivian, ME 
Davies, BM 
Burnstein, R 

Abstract

BACKGROUND: Chronic subdural haematoma (cSDH) is a common neurosurgical pathology frequently occurring in older patients. The impact of population ageing on cSDH caseload has not been examined, despite relevance for health system planning. METHODS: This is a single-centre study from the UK. Operated cases of cSDH (n = 446) for 2015-2018 were identified. Crude and directly standardised incidence rates were calculated. Medline and EMBASE were systematically searched to identify studies reporting on the incidence of cSDH by year, so an estimate of rate of incidence change could be determined. Local incidence rates were then applied to population projections for local catchment area to estimate operated cSDH numbers at 5 yearly intervals due to shifting demographics. RESULTS: We identified nine studies presenting incidence estimates. Crude estimates for operative cases ranged from 1.3/100,000/year (1.4-2.2) to 5.3/100,000/year (4.3-6.6). When non-operated cases were included, incidence was higher: 8.2/100,000/year (6.0-11.2) to 48/100,000/year (37.7-61.1). Four pairs of studies demonstrated incidence rate increases of 200-600% over the last 50 years, but data was deemed too heterogeneous to generate formal estimate of incidence change. Local crude incidence of operated cSDH was 3.50/100,000/year (3.19-3.85). Directly standardised incidence was 1.58/100,000/year (1.26-1.90). After applying local incidence rates to population projections, case numbers were predicted to increase by 53% over the next 20 years. CONCLUSIONS: The incidence of cSDH is increasing. We project a 53% increase in operative caseload within our region by 2040. These are important findings for guiding future healthcare planning.

Description

Keywords

Chronic subdural haematoma, Epidemiology, Health service planning, Incidence, Aged, Aging, Hematoma, Subdural, Chronic, Humans, Incidence

Journal Title

Acta Neurochir (Wien)

Conference Name

Journal ISSN

0001-6268
0942-0940

Volume Title

163

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Wellcome Trust (204017/Z/16/Z)
DJS is supported by a Wellcome Trust Clinician PhD Fellowship (overarching grant number: 204017/Z/16/Z) This work has arisen from a Wellcome Trust funded Clinician PhD Fellowship (to DJS) and, being as the work was funded, in whole or in part, by the Wellcome Trust (Grant number: 204017/Z/16/Z. A CC BY or equivalent licence will be applied to any Author Accepted Manuscript (AAM) arising from this submission, in accordance with the grant’s open access conditions. The research was supported by the National Institute for Health Research (NIHR) Brain Injury MedTech Co-operative based at Cambridge University Hospitals NHS Foundation Trust and University of Cambridge. The views are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.