title: Influence of antiplatelet therapy on postoperative recurrence of chronic subdural hematoma: a multicenter retrospective study in 719 patients.
abstract: OBJECTIVE
  The present study tested the hypothesis of whether antiplatelet agents (APA) induce chronic subdural hematoma (CSDH) recurrence via a platelet aggregation inhibitory effect.
  
  
  METHODS
  We examined risk factors for CSDH recurrence, focusing on APA, in 719 consecutive patients who admitted to three tertiary hospitals and underwent burr-hole craniostomy and irrigation for CSDH. This was a multicenter, retrospective, observational study.
  
  
  RESULTS
  Age, sex, history of diabetes mellitus, hypertension, chronic renal failure, alcohol consumption habits, consciousness disturbance on admission, or preoperative CT density was not associated with recurrence. Subdural drainage was significantly associated with less recurrence. Preoperative oral APA administration was significantly associated with more recurrence. The recurrence rate of CSDH in non-APA group was 11% if surgery was performed on admission. However, if surgery was performed immediately after discontinuation of oral APA administration, the recurrence rate in APA group significantly increased to 32% (p value<0.0001; odds ratio, 3.77; 95% confidence interval, 1.72-8.28). The effect of APA on CSDH recurrence gradually diminished as the number of days until initial surgery, after stopping APA, increased.
  
  
  CONCLUSIONS
  Antiplatelet therapy significantly influences the recurrence of CSDH.
authors.affiliation: Department of Neurosurgery, Chiba Rehabilitation Center, 1-45-2 Hondacho, Midori-ku, Chiba-shi, Chiba 266-0005, Japan. Electronic address: wadam6222@yahoo.co.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Wada
authors.affiliation: Department of Neurosurgery, Chiba Central Medical Center, 1835-1 Kasoricho, Wakaba-ku, Chiba 264-0017, Japan.
authors.forename: Iwao
authors.initials: I
authors.lastname: Yamakami
authors.affiliation: Department of Neurological Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-0856, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Department of Neurosurgery, Sanmu Medical Center, 167 Naruto, Sanmu-shi, Chiba 289-1326, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Kimitsu Chuo Hospital, 1010 Sakurai, Kisarazu-shi, Chiba 292-8535, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Suda
authors.affiliation: Department of Neurosurgery, Chiba Cardiovascular Center, 575 Tsurumai, Ichihara-shi, Chiba 290-0512, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ono
authors.affiliation: Department of Neurological Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-0856, Japan.
authors.forename: Naokatsu
authors.initials: N
authors.lastname: Saeki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000139:chemically induced* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet agents; Hematoma; Recurrence; Risk factors; Subdural