How Often Do Patients Need Retreatment After Surgery for Subdural Hematoma? A Nationwide Readmission Database Analysis

Abstract

Background The incidence of subdural hematoma is increasing as the average age in the United States rises, with reported high recurrence and reoperation rates. We therefore aimed to have a better understanding of retreatment following surgical evacuation of subdural hematoma in real‐world practice. Methods Data were extracted from the latest available Nationwide Readmissions Database (2016–2019). Adult patients diagnosed with subdural hematoma who had burr‐hole or craniotomy were included in the study. Results Retreatment rates were relatively low in both cohorts, with patients in the burr‐hole cohort having a slightly higher rate of retreatment compared with the craniotomy cohort (8.4% versus 6.6%, P <0.001). The majority (>95%) of retreatments occurred within 90 days of initial treatment, and further follow‐up did not demonstrably increase retreatment on Kaplan–Meier analysis. Retreatment rates remained consistent during the 4‐year study period in both burr‐hole (7.2%–10.4%), and craniotomy cohorts (6.4%–6.8%). Conclusions Analysis of a large national database of unselected patients shows retreatment rates after surgery for subdural hematoma are lower than suggested by prior studies. Almost all retreatments occur within 90 days after initial treatment, which may have implications for length of follow‐up for such patients.