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

Abstract

AbstractBackground and purposeThe incidence of subdural hematoma (SDH) is increasing as the average age in the US rises, with reported high recurrence and reoperation rates. We therefore aimed to have a better understanding of retreatment following surgical evacuation of SDH in real-world practice.MethodsData were extracted from the latest available Nationwide Readmissions Database (2016-2019). Adult patients diagnosed with SDH who had burr-hole or craniotomy were included in the study.ResultsRetreatment rates were relatively low in both cohorts, with patients in the burr-hole cohort having a slightly higher rate of retreatment compared to the craniotomy cohort (8.4% vs 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 four-year study period in both burr-hole (7.2%-10.4%), and craniotomy cohorts (6.4%-6.8%).ConclusionsAnalysis of a large national database of unselected patients shows retreatment rates after surgery for SDH 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.