Effect of Atorvastatin Calcium in Preventing Postoperative Recurrence of Chronic Subdural Hematoma and Analysis of Influencing Factors

doi:10.3969/j.issn.1674-3245.2025.01.036

Abstract：Objective To investigate the effect of atorvastatin calcium in preventing postoperative recurrence of chronic subdural hematoma (CSDH) and analyze related factors. Methods A total of 248 patients with CSDH from Lujiang County Traditional Chinese Medicine Hospital between May 2021 and June 2023 were retrospectively selected and divided into a conventional group (n=58) and a combined group (n=190) according to different treatment protocols. The conventional group received only burr hole drainage, while the combined group received additional oral atorvastatin calcium on top of the conventional treatment. After a 2-month treatment period, intra-group comparisons of neurological deficit scores (NIHSS) and activities of daily living (ADL) scores before and after treatment were conducted, as well as inter-group comparisons of clinical efficacy and recurrence rates within 6 months of follow-up. Clinical baseline data of the combined group were collected, and patients were divided into a recurrence group and a non-recurrence group based on whether they experienced postoperative recurrence of CSDH. Single-factor analysis was performed between the two groups to screen for factors related to the prevention of postoperative recurrence by atorvastatin calcium, and binary logistic regression analysis was conducted on the relevant factors to identify independent influencing factors. Results After treatment, the total effective rate of the combined group was 93.68% (178/190), significantly higher than that of the conventional group (75.86%, 44/58), with a statistically significant difference (P<0.05). After treatment, both groups showed significant reductions in NIHSS scores, with the combined group having lower scores than the conventional group (t=23.604, P<0.001). Both groups also showed significant improvements in ADL scores, with the combined group scoring higher than the conventional group (t=13.330, P<0.001). The recurrence rate of the combined group was 13.68% (26/190), significantly lower than that of the conventional group (37.93%, 22/58), with a statistically significant difference (χ²=9.166, P=0.003). Single-factor analysis results indicated that preoperative anticoagulant use, duration of illness, hematoma density, hematoma type, and preoperative midline shift were all related factors affecting the preventive effect of atorvastatin calcium on postoperative recurrence of CSDH (P<0.05). Among these, mixed-density/high-density hematoma and compartmentalized hematoma were identified as independent risk factors influencing the preventive effect of atorvastatin calcium on postoperative recurrence of CSDH (P<0.05). Conclusion The combination of atorvastatin calcium and burr hole drainage shows significant efficacy in treating CSDH and can effectively reduce the postoperative recurrence rate. Additionally, high-density hematoma and compartmentalized hematoma may affect the preventive effect of atorvastatin calcium, and treatment strategies can be adjusted accordingly to reduce the recurrence probability of CSDH.