Recurrence risk and establishment of a predictive model following neuroendoscopic hematoma evacuation in patients with chronic subdural hematoma
Wang Zhongwei
Wu Huanli
Yang Fei
Abstract：Objective To analyze the recurrence risk after neuroendoscopic hematoma evacuation of chronic subdural hematoma(CSDH)and establish a predictive model for recurrence.Methods The clinical data of 214 patients with CSDH who underwent neuroendoscopic hematoma evacuation were analyzed retrospectively.Patients were divided into recurrent group and non-recurrent group based on hematoma recurrence status.Factors influencing recurrence after neuroendoscopic surgery were analyzed,and a logistic prediction model was constructed.Results Among the 214 patients with CSDH,28 recurred 3 months after surgery,with a recurrence rate of 13.08%(28/214).Compared to the non-recurrence group,the recurrence group had a higher preoperative hematoma volume,a larger postoperative drainage volume,a lower dosage of urokinase,and a higher proportion of patients with a preoperative midline shift>10 mm and a preoperative hematoma maximum thickness(PHMT)>20mm(all P<0.05).Multivariate Logistic analysis revealed that larger preoperative hematoma volume,preoperative midline shift>10mm,PHMT>20mm,larger postoperative drainage volume,and lower dosage of urokinase were independent risk factors for recurrence of CSDH patients after neuroendoscopic hematoma evacuation(P<0.05).Based on the results of multivariate logistic regression analysis,a predictive model was established:Logit(P)=6.314+0.789×preoperative hematoma volume+1.941×preoperative midline shift+1.473×PMHT+1.397×postoperative drainage volume+0.951×urokinase dosage.The area under curve(AUC)of the predictive model was 0.921,with a sensitivity of 92.86%and a specificity of 81.72%.Conclusions The recurrence of CSDH patients after neuroendoscopic hematoma evacuation is the result of multiple factors.Clinical attention should be paid to factors such as the preoperative hematoma volume,preoperative midline shift,PMHT,postoperative drainage volume,and urokinase dosage.The logistic regression model constructed based on these factors has good predictive value and can provide reference for clinical intervention.
Keywords：hematomasubduralchronicneuroendoscopesrecurrenceinfluencing factorsprediction model
Publication Date：2024-08-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 474-478 )