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Risk factors for de...
Risk factors for developing subdural hematoma : a registry-based study in 1457 patients with shunted idiopathic normal pressure hydrocephalus
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- Gasslander, Johan (author)
- Linköpings universitet,Umeå universitet,Institutionen för farmakologi och klinisk neurovetenskap,Departments of Cardiology and Health, Medicine and Caring Services, Linkoping University, Vrinnevi General Hospital Norrköping,Institutionen för hälsa, medicin och vård,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken i Norrköping,Umea Univ, Sweden
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- Sundström, Nina (author)
- Umeå universitet,Radiofysik,Umea Univ, Sweden
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- Eklund, Anders, 1965- (author)
- Umeå universitet,Radiofysik,Umea Univ, Sweden
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- Koskinen, Lars-Owe D., Professor, 1955- (author)
- Umeå universitet,Neurovetenskaper,Umea Univ, Sweden
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- Malm, Jan, Professor, 1957- (author)
- Umeå universitet,Neurovetenskaper,Umea Univ, Sweden
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(creator_code:org_t)
- American Association of Neurological Surgeons, 2021
- 2021
- English.
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In: Journal of Neurosurgery. - : American Association of Neurological Surgeons. - 0022-3085 .- 1933-0693. ; 134:2, s. 668-677
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.3...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- OBJECTIVE: Subdural hematomas and hygromas (SDHs) are common complications in idiopathic normal pressure hydrocephalus (iNPH) patients with shunts. In this registry-based study, patients with shunted iNPH were screened nationwide to identify perioperative variables that may increase the risk of SDH.METHODS: The Swedish Hydrocephalus Quality Registry was reviewed for iNPH patients who had undergone shunt surgery in Sweden in 2004-2014. Potential risk factors for SDH were recorded preoperatively and 3 months after surgery. Drug prescriptions were identified from a national pharmacy database. Patients who developed SDHs were compared with those without SDHs.RESULTS: The study population consisted of 1457 patients, 152 (10.4%) of whom developed an SDH. Men developed an SDH more often than women (OR 2.084, 95% CI 1.421-3.058, p < 0.001). Patients on platelet aggregation inhibitors developed an SDH more often than those who were not (OR 1.733, 95% CI 1.236-2.431, p = 0.001). At surgery, shunt opening pressures had been set 5.9 mm H2O lower in the SDH group than in the no-SDH group (109.6 ± 24.1 vs 115.5 ± 25.4 mm H2O, respectively, p = 0.009). Antisiphoning devices (ASDs) were used in 892 patients but did not prevent SDH. Mean opening pressures at surgery and the follow-up were lower with shunts with an ASD, without causing more SDHs. No other differences were seen between the groups.CONCLUSIONS: iNPH patients in this study were diagnosed and operated on in routine practice; thus, the results represent everyday care. Male sex, antiplatelet medication, and a lower opening pressure at surgery were risk factors for SDH. Physical status and comorbidity were not. ASD did not prevent SDH, but a shunt with an ASD allowed a lower opening pressure without causing more SDHs.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- hydrocephalus
- normal pressure
- hygroma
- chronic subdural hematoma
- cerebrospinal shunt
- complications
- neurokirurgi
- Neurosurgery
- Neurology
- neurologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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