Transition of a Clinical Practice to Use of Subdural Drains after Burr Hole Evacuation of Chronic Subdural Hematoma : The Helsinki Experience

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dc.contributor.author Tommiska, Pihla
dc.contributor.author Lonnrot, Kimmo
dc.contributor.author Raj, Rahul
dc.contributor.author Luostarinen, Teemu
dc.contributor.author Kivisaari, Riku
dc.date.accessioned 2020-08-13T21:42:57Z
dc.date.available 2021-12-18T03:45:23Z
dc.date.issued 2019-09
dc.identifier.citation Tommiska , P , Lonnrot , K , Raj , R , Luostarinen , T & Kivisaari , R 2019 , ' Transition of a Clinical Practice to Use of Subdural Drains after Burr Hole Evacuation of Chronic Subdural Hematoma : The Helsinki Experience ' , World Neurosurgery , vol. 129 , pp. E614-E626 . https://doi.org/10.1016/j.wneu.2019.05.230
dc.identifier.other PURE: 126522335
dc.identifier.other PURE UUID: 8932b848-ed17-4cbb-be04-9a8ab61970b4
dc.identifier.other WOS: 000481607900078
dc.identifier.other ORCID: /0000-0003-4361-1007/work/61350277
dc.identifier.uri http://hdl.handle.net/10138/318309
dc.description.abstract BACKGROUND: A number of randomized controlled trials have shown the benefit of drain placement in the operative treatment of chronic subdural hematoma (CSDH); however, few reports have described real-life results after adoption of drain placement into clinical practice. We report the results following a change in practice at Helsinki University Hospital from no drain to subdural drain (SD) placement after burr hole craniostomy for CSDH. METHODS: We conducted a retrospective observational study of consecutive patients undergoing burr hole craniostomy for CSDH. We compared outcomes between a 6-month period when SD placement was arbitrary (Julye December 2015) and a period when SD placement for 48 hours was routine (July-December 2017). Our primary outcome of interest was recurrence of CSDH necessitating reoperation within 6 months. Patient outcomes, infections, and other complications were assessed as well. RESULTS: A total of 161 patients were included, comprising 71 (44%) in the drain group and 90 (56%) in the non-drain group. There were no significant differences in age, comorbidities, history of trauma, or use of antithrombotic agents between the 2 groups (P > 0.05 for all). Recurrence within 6 months occurred in 18% of patients in the non-drain group, compared with 6% in the drain group (odds ratio, 0.28; 95% confidence interval, 0.09-0.87; P = 0.028). There were no differences in neurologic outcomes (P = 0.72), mortality (P = 0.55), infection rate (P = 0.96), or other complications (P = 0.20). CONCLUSIONS: The change in practice from no drain to use of an SD after burr hole craniostomy for CSDH effectively reduced the 6-month recurrence rate with no effect on patient outcomes, infections, or other complications. en
dc.format.extent 13
dc.language.iso eng
dc.relation.ispartof World Neurosurgery
dc.rights cc_by_nc_nd
dc.rights unspecified
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Burr hole
dc.subject Chronic subdural hematoma
dc.subject Drain
dc.subject Neurosurgery
dc.subject Recurrence
dc.subject Subdural drain
dc.subject Surgery
dc.subject CLOSED-SYSTEM DRAINAGE
dc.subject INTERNATIONAL SURVEY
dc.subject QUESTIONNAIRE SURVEY
dc.subject RISK-FACTORS
dc.subject MANAGEMENT
dc.subject RECURRENCE
dc.subject SUBACUTE
dc.subject IRRIGATION
dc.subject PREDICTORS
dc.subject PLACEMENT
dc.subject 3112 Neurosciences
dc.subject 3124 Neurology and psychiatry
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Transition of a Clinical Practice to Use of Subdural Drains after Burr Hole Evacuation of Chronic Subdural Hematoma : The Helsinki Experience en
dc.type Article
dc.contributor.organization HUS Neurocenter
dc.contributor.organization Neurokirurgian yksikkö
dc.contributor.organization Department of Neurosciences
dc.contributor.organization Clinicum
dc.contributor.organization Helsinki University Hospital Area
dc.contributor.organization HUS Perioperative, Intensive Care and Pain Medicine
dc.contributor.organization Department of Diagnostics and Therapeutics
dc.contributor.organization Anestesiologian yksikkö
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.wneu.2019.05.230
dc.relation.issn 1878-8750
dc.rights.accesslevel openAccess
dc.type.version acceptedVersion
dc.type.version publishedVersion

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