TY - JOUR
T1 - Long-term health outcomes in survivors after chronic subdural haematoma
AU - Moffatt, Claire E.
AU - Hennessy, Maria J.
AU - Marshman, Laurence A.G.
AU - Manickam, Appukutty
PY - 2019/8
Y1 - 2019/8
N2 - Chronic subdural haematoma (CSDH) is the most common neurosurgical presentation among the elderly. Although initially considered a non-threatening event, recent studies have highlighted poor long-term survival post-CSDH. Currently, there is a paucity of information regarding long-term health outcome in survivors after CSDH post-intervention. The objective of this research was to assess long-term functional, cognitive, and mental health outcome after CSDH. CSDH patients were administered a telephone-based assessment including a Demographic Questionnaire, Functional Activities Questionnaire (FAQ), Cognitive Telephone Screening Instrument (COGTEL), Mental Health Continuum-Short Form (MHC-SF), and the Geriatric Depression Scale (GDS). Results were obtained in n = 51 patients. CSDH patients were assessed at 5.5 + 2.1 years after CSDH and results were compared to age/gender matched controls (n = 52). Comorbidities were significantly greater in CSDH patients at the time of assessment (χ2 = 35.47, P <.01). CSDH patients demonstrated a significant reduction in functional independence (FAQ, P <.001) and Verbal Short-Term Memory (COGTEL, P =.048). Potential negative trends were observed for Verbal Long-Term Memory (P =.06) and Inductive Reasoning (P =.07). CSDH patients also demonstrated significantly poorer emotional, psychological and social well-being (MHC-SF: Emotional, P =.003; Psychological, P =.001; and Social, P <.001), with increased depressive symptomatology (GDS, P <.001). In addition to known decreased long-term survival, CSDH survivors demonstrated poorer long-term functional, cognitive and mental health outcomes than controls. Pre-existent comorbidities were also more prevalent. CSDH is therefore a sentinel health event: survivors represent a vulnerable group who require long-term, comprehensive, person-centred care. This is the first study of long term CSDH health outcomes.
AB - Chronic subdural haematoma (CSDH) is the most common neurosurgical presentation among the elderly. Although initially considered a non-threatening event, recent studies have highlighted poor long-term survival post-CSDH. Currently, there is a paucity of information regarding long-term health outcome in survivors after CSDH post-intervention. The objective of this research was to assess long-term functional, cognitive, and mental health outcome after CSDH. CSDH patients were administered a telephone-based assessment including a Demographic Questionnaire, Functional Activities Questionnaire (FAQ), Cognitive Telephone Screening Instrument (COGTEL), Mental Health Continuum-Short Form (MHC-SF), and the Geriatric Depression Scale (GDS). Results were obtained in n = 51 patients. CSDH patients were assessed at 5.5 + 2.1 years after CSDH and results were compared to age/gender matched controls (n = 52). Comorbidities were significantly greater in CSDH patients at the time of assessment (χ2 = 35.47, P <.01). CSDH patients demonstrated a significant reduction in functional independence (FAQ, P <.001) and Verbal Short-Term Memory (COGTEL, P =.048). Potential negative trends were observed for Verbal Long-Term Memory (P =.06) and Inductive Reasoning (P =.07). CSDH patients also demonstrated significantly poorer emotional, psychological and social well-being (MHC-SF: Emotional, P =.003; Psychological, P =.001; and Social, P <.001), with increased depressive symptomatology (GDS, P <.001). In addition to known decreased long-term survival, CSDH survivors demonstrated poorer long-term functional, cognitive and mental health outcomes than controls. Pre-existent comorbidities were also more prevalent. CSDH is therefore a sentinel health event: survivors represent a vulnerable group who require long-term, comprehensive, person-centred care. This is the first study of long term CSDH health outcomes.
KW - Chronic
KW - Health
KW - Outcome
KW - Subdural Haematoma
UR - http://www.scopus.com/inward/record.url?scp=85065439706&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2019.04.039
DO - 10.1016/j.jocn.2019.04.039
M3 - Article
C2 - 31088769
AN - SCOPUS:85065439706
VL - 66
SP - 133
EP - 137
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
SN - 0967-5868
ER -