Long-term health outcomes in survivors after chronic subdural haematoma
Journal Publication ResearchOnline@JCUAbstract
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 (v2 = 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.
Journal
Journal of Clinical Neuroscience
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Volume
66
ISBN/ISSN
1532-2653
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Pages Count
5
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Publisher
Elsevier
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DOI
10.1016/j.jocn.2019.04.039