Recurrence of subdural haematoma in a population-based cohort - Risks and predictive factors

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Objectives To estimate the risks of and identify predictors for recurrent subdural haematoma in surgically and conservatively treated patients. Methods The cohort comprised all individuals diagnosed with a first-time subdural hematoma in Denmark 1996-2011. Information on potential predictors was retrieved from the Danish health registers. Cumulative recurrence risks were estimated using the Aalen-Johansen estimator. Rate ratios (RR) were estimated using Poisson regression. Results Among 10,158 individuals with a subdural hematoma, 1,555 had a recurrent event. The cumulative risk of recurrent subdural hematoma was 9% at 4 weeks after the primary bleeding, increasing to and stabilising at 14% after one year. Predictors associated with recurrence were: Male sex (RR 1.60, 95% CI:1.43-1.80), older age (>70 years compared to 20- 49 years; RR 1.41, 95% CI: 1.21-1.65), alcohol addiction (RR 1.20, 95% CI:1.04-1.37), surgical treatment (RR 1.76, 95% CI:1.58-1.96), trauma diagnoses (RR 1.14, 95% CI:1.03- 1.27), and diabetes mellitus (RR 1.40, 95% CI:1.11-1.74). Out of a selected combination of risk factors, the highest cumulative 1-year recurrence risks for subdural hematoma of 25% (compared to 14% for all patients) was found in surgically treated males with diabetes mellitus. Conclusions The recurrence risk of subdural hematoma is largely limited to the first year. Patient characteristics including co-morbidities greatly influence the recurrence risk of SDH, suggesting that individualized prognostic guidance and follow-up is needed.

Original languageEnglish
Article numbere0140450
JournalPLoS ONE
Volume10
Issue number10
ISSN1932-6203
DOIs
Publication statusPublished - 14 Oct 2015
Externally publishedYes

ID: 258217923