重新审视退役军人非急性硬膜下血肿的手术疗效：菲律宾一家三甲医院的回顾性分析》（Revisiting the Surgical Outcomes of Non-Acute Subdural Hematomas among Retired Military Personnel : A Single Tertiary Hospital Retrospective Analysis in the Philippines）。
{"title":"重新审视退役军人非急性硬膜下血肿的手术疗效：菲律宾一家三甲医院的回顾性分析》（Revisiting the Surgical Outcomes of Non-Acute Subdural Hematomas among Retired Military Personnel : A Single Tertiary Hospital Retrospective Analysis in the Philippines）。","authors":"Leo E Trinidad, Rhoby U Orata","doi":"10.3340/jkns.2024.0099","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Subdural hematomas (SDH) are classified clinically and/or radiologically as acute (ASDH), subacute (SSDH) and chronic (CSDH). The management differ depending on their classification, with only the ASDH having a definite accepted surgical guideline. Non-acute SDH, specifically SSDH and CSDH have no clear surgical guidelines but are managed similarly in some literature. This study was conducted to determine if there is a difference in outcomes among surgically managed non-acute SDH in a specific elderly population of retired military personnel.</p><p><strong>Methods: </strong>This is a pre-pandemic retrospective study that utilized data obtained from January 2016 to April 2019, in a subspecialty tertiary hospital that caters to retired military personnel or veterans, in the Philippines. After chart review and application of inclusion and exclusion criteria, twenty-one patients were included, all military retirees, with age 56 years old and above. Chart review and electronic database were retrieved to extract relevant information.</p><p><strong>Results: </strong>In this study, a term 'mixed-type subdural hematoma' (MSDH) was proposed to encompass SDH that have mixed hypo-and-hyperdensity on preoperative CT scan and were subsequently found to have bright red liquefied hematoma instead of the classic engine machinery oil fluid found in a CSDH. Based on the observed cohort, 9 out of 11 CSDH patients attained the Glasgow Outcome Scale Extended (GOS-E) score of 8 while all the respondents in the MSDH group attained the same GOS-E score underscoring the need for early intervention in patients with non-acute subdural hematoma. Moreover, the outcomes of both MSDH and CSDH are comparable with low mortality rate (~9.5%) and immediate postoperative improvement (~90%).</p><p><strong>Conclusion: </strong>MSDH and CSDH, although classified separately using clinical and/or radiologic means, can collectively be categorized as a non-acute SDH and can be managed safely and effectively with burr hole surgery.</p>","PeriodicalId":16283,"journal":{"name":"Journal of Korean Neurosurgical Society","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Revisiting the Surgical Outcomes of Non-Acute Subdural Hematomas among Retired Military Personnel : A Single Tertiary Hospital Retrospective Analysis in the Philippines.\",\"authors\":\"Leo E Trinidad, Rhoby U Orata\",\"doi\":\"10.3340/jkns.2024.0099\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Subdural hematomas (SDH) are classified clinically and/or radiologically as acute (ASDH), subacute (SSDH) and chronic (CSDH). The management differ depending on their classification, with only the ASDH having a definite accepted surgical guideline. Non-acute SDH, specifically SSDH and CSDH have no clear surgical guidelines but are managed similarly in some literature. This study was conducted to determine if there is a difference in outcomes among surgically managed non-acute SDH in a specific elderly population of retired military personnel.</p><p><strong>Methods: </strong>This is a pre-pandemic retrospective study that utilized data obtained from January 2016 to April 2019, in a subspecialty tertiary hospital that caters to retired military personnel or veterans, in the Philippines. After chart review and application of inclusion and exclusion criteria, twenty-one patients were included, all military retirees, with age 56 years old and above. Chart review and electronic database were retrieved to extract relevant information.</p><p><strong>Results: </strong>In this study, a term 'mixed-type subdural hematoma' (MSDH) was proposed to encompass SDH that have mixed hypo-and-hyperdensity on preoperative CT scan and were subsequently found to have bright red liquefied hematoma instead of the classic engine machinery oil fluid found in a CSDH. Based on the observed cohort, 9 out of 11 CSDH patients attained the Glasgow Outcome Scale Extended (GOS-E) score of 8 while all the respondents in the MSDH group attained the same GOS-E score underscoring the need for early intervention in patients with non-acute subdural hematoma. 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Revisiting the Surgical Outcomes of Non-Acute Subdural Hematomas among Retired Military Personnel : A Single Tertiary Hospital Retrospective Analysis in the Philippines.
Objective: Subdural hematomas (SDH) are classified clinically and/or radiologically as acute (ASDH), subacute (SSDH) and chronic (CSDH). The management differ depending on their classification, with only the ASDH having a definite accepted surgical guideline. Non-acute SDH, specifically SSDH and CSDH have no clear surgical guidelines but are managed similarly in some literature. This study was conducted to determine if there is a difference in outcomes among surgically managed non-acute SDH in a specific elderly population of retired military personnel.
Methods: This is a pre-pandemic retrospective study that utilized data obtained from January 2016 to April 2019, in a subspecialty tertiary hospital that caters to retired military personnel or veterans, in the Philippines. After chart review and application of inclusion and exclusion criteria, twenty-one patients were included, all military retirees, with age 56 years old and above. Chart review and electronic database were retrieved to extract relevant information.
Results: In this study, a term 'mixed-type subdural hematoma' (MSDH) was proposed to encompass SDH that have mixed hypo-and-hyperdensity on preoperative CT scan and were subsequently found to have bright red liquefied hematoma instead of the classic engine machinery oil fluid found in a CSDH. Based on the observed cohort, 9 out of 11 CSDH patients attained the Glasgow Outcome Scale Extended (GOS-E) score of 8 while all the respondents in the MSDH group attained the same GOS-E score underscoring the need for early intervention in patients with non-acute subdural hematoma. Moreover, the outcomes of both MSDH and CSDH are comparable with low mortality rate (~9.5%) and immediate postoperative improvement (~90%).
Conclusion: MSDH and CSDH, although classified separately using clinical and/or radiologic means, can collectively be categorized as a non-acute SDH and can be managed safely and effectively with burr hole surgery.
期刊介绍：
The Journal of Korean Neurosurgical Society (J Korean Neurosurg Soc) is the official journal of the Korean Neurosurgical Society, and published bimonthly (1st day of January, March, May, July, September, and November). It launched in October 31, 1972 with Volume 1 and Number 1. J Korean Neurosurg Soc aims to allow neurosurgeons from around the world to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism. This journal publishes Laboratory Investigations, Clinical Articles, Review Articles, Case Reports, Technical Notes, and Letters to the Editor. Our field of interest involves clinical neurosurgery (cerebrovascular disease, neuro-oncology, skull base neurosurgery, spine, pediatric neurosurgery, functional neurosurgery, epilepsy, neuro-trauma, and peripheral nerve disease) and laboratory work in neuroscience.
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