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Published in: Acta Neurochirurgica 1/2024

Open Access 01-12-2024 | Original Article

Passive or active drainage system for chronic subdural haematoma—a single-center retrospective follow-up study

Authors: Paulina Majewska, Mattis A. Madsbu, Lisa Millgård Sagberg, Sasha Gulati, Asgeir Store Jakola, Ole Solheim

Published in: Acta Neurochirurgica | Issue 1/2024

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Abstract

Background

Postoperative drainage systems have become a standard treatment for chronic subdural hematoma (CSDH). We previously compared treatment results from three Scandinavian centers using three different postoperative drainage systems and concluded that the active subgaleal drainage was associated with lower recurrence and complication rates than the passive subdural drainage. We consequently changed clinical practice from using the passive subdural drainage to the active subgaleal drainage.

Objective

The aim of the present study was to assess a potential change in reoperation rates for CSDH after conversion to the active subgaleal drainage.

Methods

This single-center cohort study compared the reoperation rates for recurrent same-sided CSDH and postoperative complication rates between patients treated during two study periods (passive subdural drainage cohort versus active subgaleal drainage cohort).

Results

In total, 594 patients were included in the study. We found no significant difference in reoperation rates between the passive subdural drain group and the active subgaleal drain group (21.6%, 95% CI 17.5–26.4% vs. 18.0%, 95% CI 13.8–23.2%; p = 0.275). There was no statistical difference in the rate of serious complications between the groups. The operating time was significantly shorter for patients operated with the active subgaleal drain than patients with the passive subdural drain (32.8 min, 95% CI 31.2–34.5 min vs. 47.6 min, 95% CI 44.7–50.4 min; p < 0.001).

Conclusions

Conversion from the passive subdural to the active subgaleal drainage did not result in a clear reduction of reoperation rates for CSDH in our center.
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Metadata
Title
Passive or active drainage system for chronic subdural haematoma—a single-center retrospective follow-up study
Authors
Paulina Majewska
Mattis A. Madsbu
Lisa Millgård Sagberg
Sasha Gulati
Asgeir Store Jakola
Ole Solheim
Publication date
01-12-2024
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 1/2024
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-024-05967-6

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