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Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients

Chronic subdural hematoma (cSDH) is a common neurosurgical condition that can cause severe morbidity and mortality. cSDH recurs after surgical evacuation in 5–30% of patients, but drains may help reduce this risk. We aimed to investigate the effect of drainage versus no drainage on the rates of recu...

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Autores principales: Aljabali, Ahmed, Sharkawy, Aya Mohammed, Jaradat, Belal, Serag, Ibrahim, Al-dardery, Nada Mostafa, Abdelhady, Mariam, Abouzid, Mohamed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509130/
https://www.ncbi.nlm.nih.gov/pubmed/37726502
http://dx.doi.org/10.1007/s10143-023-02153-7
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author Aljabali, Ahmed
Sharkawy, Aya Mohammed
Jaradat, Belal
Serag, Ibrahim
Al-dardery, Nada Mostafa
Abdelhady, Mariam
Abouzid, Mohamed
author_facet Aljabali, Ahmed
Sharkawy, Aya Mohammed
Jaradat, Belal
Serag, Ibrahim
Al-dardery, Nada Mostafa
Abdelhady, Mariam
Abouzid, Mohamed
author_sort Aljabali, Ahmed
collection PubMed
description Chronic subdural hematoma (cSDH) is a common neurosurgical condition that can cause severe morbidity and mortality. cSDH recurs after surgical evacuation in 5–30% of patients, but drains may help reduce this risk. We aimed to investigate the effect of drainage versus no drainage on the rates of recurrence and mortality, as well as the clinical outcomes of cSDH. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, Cochrane Library, Scopus, and Web of Science) to identify eligible studies reported up to June 2022. Using Review Manager software, we reported four primary outcomes as odds ratios (ORs) and confidence intervals (CIs). The meta-analysis included a total of 10 studies with 1961 patients. The use of drainage was found to be significantly more effective than non-drainage in reducing the “mortality rate” (OR = 0.65, 95% CI 0.43 to 0.97; P = 0.04), the “recurrence rate” (OR = 0.39, 95% CI 0.28 to 0.55; P < 0.00001), and occurrence of “gross focal neurological deficit” (OR = 0.58, 95% CI 0.37 to 0.89; P = 0.01). No significant difference was found in the occurrence of a Glasgow Coma Scale score of 15 (OR = 1.21, 95% CI 0.84 to 1.76; P = 0.30). The use of drains after burr-hole irrigation reduces the recurrence, mortality, and gross focal neurological deficit rates of chronic subdural hematomas.
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spelling pubmed-105091302023-09-21 Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients Aljabali, Ahmed Sharkawy, Aya Mohammed Jaradat, Belal Serag, Ibrahim Al-dardery, Nada Mostafa Abdelhady, Mariam Abouzid, Mohamed Neurosurg Rev Review Chronic subdural hematoma (cSDH) is a common neurosurgical condition that can cause severe morbidity and mortality. cSDH recurs after surgical evacuation in 5–30% of patients, but drains may help reduce this risk. We aimed to investigate the effect of drainage versus no drainage on the rates of recurrence and mortality, as well as the clinical outcomes of cSDH. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched four electronic databases (PubMed, Cochrane Library, Scopus, and Web of Science) to identify eligible studies reported up to June 2022. Using Review Manager software, we reported four primary outcomes as odds ratios (ORs) and confidence intervals (CIs). The meta-analysis included a total of 10 studies with 1961 patients. The use of drainage was found to be significantly more effective than non-drainage in reducing the “mortality rate” (OR = 0.65, 95% CI 0.43 to 0.97; P = 0.04), the “recurrence rate” (OR = 0.39, 95% CI 0.28 to 0.55; P < 0.00001), and occurrence of “gross focal neurological deficit” (OR = 0.58, 95% CI 0.37 to 0.89; P = 0.01). No significant difference was found in the occurrence of a Glasgow Coma Scale score of 15 (OR = 1.21, 95% CI 0.84 to 1.76; P = 0.30). The use of drains after burr-hole irrigation reduces the recurrence, mortality, and gross focal neurological deficit rates of chronic subdural hematomas. Springer Berlin Heidelberg 2023-09-19 2023 /pmc/articles/PMC10509130/ /pubmed/37726502 http://dx.doi.org/10.1007/s10143-023-02153-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review
Aljabali, Ahmed
Sharkawy, Aya Mohammed
Jaradat, Belal
Serag, Ibrahim
Al-dardery, Nada Mostafa
Abdelhady, Mariam
Abouzid, Mohamed
Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
title Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
title_full Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
title_fullStr Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
title_full_unstemmed Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
title_short Drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
title_sort drainage versus no drainage after burr-hole evacuation of chronic subdural hematoma: a systematic review and meta-analysis of 1961 patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509130/
https://www.ncbi.nlm.nih.gov/pubmed/37726502
http://dx.doi.org/10.1007/s10143-023-02153-7
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