Xiaolin DU, Cheng Wang, Rukai Jiao, Xiaopeng Deng, Junquan Chen, Chengming Zhou, Kun Zhou
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Further subgroup analysis of TEG parameters revealed that patients with R values ≥ 5 had a significantly high incidence of recurrence (1.231, 95% confidence interval [CI]: 0.973-1.557], p=0.025). However, further logistic regression analysis did not reveal significant results (1.198, 95% CI: 0.855-1.680, p=0.293). Moreover, the association between the preoperative TEG parameters and the secondary outcomes was compared. Results revealed a statistically significant association between the secondary outcomes and hematoma thickness and LY30 values (p=0.039), midline shift and Angle (p=0.043), and multiplicity of the hematoma cavity and MA (p=0.022). Further, the secondary outcomes were also significantly associated with postoperative TEG parameters such as multiplicity of the hematoma cavity and LY 30 value (p=0.011) and residual hematoma at follow-up (MA, p=0.001).</p><p><strong>Conclusion: </strong>Due to the small sample size, the efficacy of TEG parameters in predicting CSDH recurrence is unclear. However, TEG parameters are associated with the imaging characteristics of CSDH, and they can also be used to predict the absorption of hematoma. Nevertheless, large-scale prospective cohort studies should be performed to further validate the findings of this study.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"644-651"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Thromboelastography in Patients with Chronic Subdural Hematoma: A Prospective Pilot Study.\",\"authors\":\"Xiaolin DU, Cheng Wang, Rukai Jiao, Xiaopeng Deng, Junquan Chen, Chengming Zhou, Kun Zhou\",\"doi\":\"10.5137/1019-5149.JTN.47482-24.2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To evaluate association between chronic subdural hematoma (CSDH) and thromboelastography (TEG).</p><p><strong>Material and methods: </strong>A prospective pilot study was conducted on 52 patients with CSDH. 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引用次数: 0
摘要
目的：慢性硬膜下血肿（CSDH）患者凝血功能障碍与预后不良风险相关。然而，血栓弹性成像（TEG）参数与CSDH之间的关系尚不清楚。材料与方法：对52例CSDH患者进行前瞻性先导研究。主要结局是CSDH严重程度、复发率和转归。次要结局是TEG参数与CSDH危险因素之间的关联。结果：比较术前TEG参数与主要结局的相关性。结果显示，主要结局与入院时修正Rankin量表评分及随访GOS评分无统计学意义。复发组与无复发组的R值差异有统计学意义（p = 0.045）。进一步对TEG参数进行亚组分析，R值≥5的患者复发率显著高（1.231,95%可信区间[CI]: 0.973 ~ 1.557], P = 0.025）。然而，进一步的logistic回归分析没有显示显著结果（1.198,95% CI: 0.855-1.680, P = 0.293）。此外，比较术前TEG参数与次要结局之间的关系。结果显示，次要结局与血肿厚度和LY30值（P = 0.039）、中线移位和角度（P = 0.043）、血肿腔数和MA （P = 0.022）有统计学意义。此外，次要结局也与术后TEG参数，如血肿腔的多样性和LY 30值（P = 0.011）和随访时的血肿残余（MA, P = 0.001）显著相关。结论：由于样本量小，TEG参数对CSDH复发的预测效果尚不明确。而TEG参数与CSDH的影像学特征相关，也可用于预测血肿的吸收情况。然而，需要进行大规模的前瞻性队列研究来进一步验证本研究的结果。
Thromboelastography in Patients with Chronic Subdural Hematoma: A Prospective Pilot Study.
Aim: To evaluate association between chronic subdural hematoma (CSDH) and thromboelastography (TEG).
Material and methods: A prospective pilot study was conducted on 52 patients with CSDH. The primary outcomes were CSDH severity, recurrence rate, and outcome. The secondary outcome was the association between TEG parameters and the risk factors of CSDH.
Results: The association between the preoperative TEG parameters and the primary outcomes was compared. Results revealed no statistically significant association between the primary outcomes and admission modified Rankin scale score and follow-up GOS score. The R values significantly differed between patients with recurrence and those without (p=0.045). Further subgroup analysis of TEG parameters revealed that patients with R values ≥ 5 had a significantly high incidence of recurrence (1.231, 95% confidence interval [CI]: 0.973-1.557], p=0.025). However, further logistic regression analysis did not reveal significant results (1.198, 95% CI: 0.855-1.680, p=0.293). Moreover, the association between the preoperative TEG parameters and the secondary outcomes was compared. Results revealed a statistically significant association between the secondary outcomes and hematoma thickness and LY30 values (p=0.039), midline shift and Angle (p=0.043), and multiplicity of the hematoma cavity and MA (p=0.022). Further, the secondary outcomes were also significantly associated with postoperative TEG parameters such as multiplicity of the hematoma cavity and LY 30 value (p=0.011) and residual hematoma at follow-up (MA, p=0.001).
Conclusion: Due to the small sample size, the efficacy of TEG parameters in predicting CSDH recurrence is unclear. However, TEG parameters are associated with the imaging characteristics of CSDH, and they can also be used to predict the absorption of hematoma. Nevertheless, large-scale prospective cohort studies should be performed to further validate the findings of this study.
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