Efficacy of single burr-hole subdural drainage and strategy of subdural urokinase injection in elderly patients with chronic subdural hematoma
LIU Jiang
ZHANG Yundong
LIU Yan
SHEN Guangjian
XU Chu
Abstract：Objective To investigate the effectiveness of drilling and drainage surgery for chronic subdural hematoma(CSDH)in elderly patients and the impact of using urokinase on clinical outcomes.Methods A retrospective analysis was conducted on 113 elderly CSDH patients admitted to our neurological disease center from February 2019 to March 2024.All patients underwent single burr-hole drainage.Modified Rankin scale(mRS)score was applied to assess clinical status at 6 months.Multivariate logistic model was employed to analyze the risk factors associated with postoperative urokinase use in CSDH patients.Results Sixty-seven patients(59.29％)received urokinase instillation through the subdural drain into the hematoma cavity.A total of 104 patients(92.04％)achieved a good prognosis at 6 months after surgery.Multivariate logistic regression analysis showed that age,preoperative hematoma size,and history of ischemic heart disease were independent influencing factors for urokinase use(P＜0.05,P＜0.01).There were no statistical differences in the length of hospital stay and incidence of complications between the patients with urokinase administration and those without(9.30±8.95 d vs 8.00±11.00 d,4.48％vs 8.70％,P＞0.05).The patients receiving urokinase injection had significantly lower mRS score at 6 months and recurrence rate at 1 year after surgery than those having no use of urokinase(P＜0.05,P＜0.01).Conclusion For elderly CSDH patients,using urokinase for subdural drainage after drilling and clearing hematoma under local anesthesia is a treatment strategy with advantages of effectiveness,safety,and low recurrence rate.
Keywords：hematomasubduralchronicrecurrencedrainageurokinase-type plasminogen activator
Publication Date：2025-12-15
Online Publishing Date：2025-12-29(First online date of this platform, not the publication date of the document)
Pages：4( 1617-1620 )