The role of angiotensin converting enzyme inhibitor in patients with chronic subdural hematoma: a Scandinavian population-based multicenter study.

• To investigate the role of angiotensin converting enzyme (ACE) inhibitors in recurrence of chronic subdural hematoma (cSDH) after burr-hole surgery.A retrospective review was conducted in a Scandinavian multicenter population-based cohort of 1252 adult cSDH patients operated with burr-hole surgery between January 1, 2005 and December 31, 2010. The risk of cSDH recurrence was assessed in users of ACE inhibitors, users of angiotensin II receptor blockers (ARB) and those without ACE inhibitor treatment (no ACE inhibitor group) using univariable and multivariable regression analyses.There were 98 users (7.8%) of ACE inhibitors, and 63 users (5%) of ARBs only. The recurrence rate in the ACE inhibitor group was 16.3% (n=16), compared to 13.3% (n=153) in the no ACE inhibitor group (p=0.39) and 14.3% (n=9) in the ARB group (p=0.73). When comparing groups, age (p=0.01), Charlson comorbidity Index (p=0.01), the use of platelet inhibitors (p=0.001) and use of anticoagulants (p=0.01) differed between the ACE inhibitor and the no ACE inhibitor group. Only age differed (p=0.03) between the ACE inhibitor and ARB groups. In the analyses adjusted for differences in baseline characteristics, ACE inhibitor treatment did not influence risk for recurrence (OR 1.2, 95 % CI 0.7-2.2 p=0.46).Use of ACE inhibitors was not associated with risk of recurrence following burrhole surgery for cSDH in this population based study..

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

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