Intravenous fluid administration may improve post-operative course of patients with chronic subdural hematoma

A retrospective study

Miroslaw Janowski, Przemyslaw Kunert

Research output: Contribution to journalArticle

Abstract

Background: The treatment of chronic subdural hematoma (cSDH) is still charged of significant risk of hematoma recurrence. Patient-related predictors and the surgical procedures themselves have been addressed in many studies. In contrast, postoperative management has infrequently been subjected to detailed analysis. Moreover variable intravenous fluid administration (IFA) was not reported in literature till now in the context of cSDH treatment. Methodology/Principal Findings: A total of 45 patients with cSDH were operated in our department via two burr hole craniostomy within one calendar year. Downward drainage was routinely left in hematoma cavity for a one day. Independent variables selected for the analysis were related to various aspects of patient management, including IFA. Two dependent variables were chosen as measure of clinical course: the rate of hematoma recurrence (RHR) and neurological status at discharge from hospital expressed in points of Glasgow Outcome Scale (GOS). Univariate and multivariate regression analyses were performed. Hematoma recurrence with subsequent evacuation occurred in 7 (15%) patients. Univariate regression analysis revealed that length of IFA after surgery influenced both dependent variables: RHR (p = 0.045) and GOS (p = 0.023). Multivariate regression performed by backward elimination method confirmed that IFA is a sole independent factor influencing RHR. Post hoc dichotomous division of patients revealed that those receiving at least 2000 ml/day over 3 day period revealed lower RHR than the group with less intensive IFA. (p = 0.031). Conclusions/Significance: IFA has been found to be a sole factor influencing both: RHR and GOS. Based on those results we may recommend administration of at least 2000 ml per 3 days post-operatively to decrease the risk of hematoma recurrence.

Original languageEnglish (US)
Article numbere35634
JournalPLoS One
Volume7
Issue number4
DOIs
StatePublished - Apr 20 2012
Externally publishedYes

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Hematoma, Subdural, Chronic
hematoma
retrospective studies
Hematoma
Intravenous Administration
Retrospective Studies
Fluids
Recurrence
Glasgow Outcome Scale
Regression Analysis
fluids
surgery
Regression analysis
Surgery
Drainage
Multivariate Analysis
disease course

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Intravenous fluid administration may improve post-operative course of patients with chronic subdural hematoma : A retrospective study. / Janowski, Miroslaw; Kunert, Przemyslaw.

In: PLoS One, Vol. 7, No. 4, e35634, 20.04.2012.

Research output: Contribution to journalArticle

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