title: To Drain or Two Drains: Recurrences in Chronic Subdural Hematomas.
abstract: BACKGROUND
  Chronic subdural hematoma (cSDH) is a common neurosurgical condition, with an estimated incidence of 3-15.5 per 100,000 people, with significantly higher rates in the elderly population. Recurrence rates range from 2%-37% after surgical drainage. Studies have shown that leaving a drain postoperatively can reduce recurrence rates, but studies have not looked at whether there is a difference between leaving 1 or 2 drains.
  
  
  METHODS
  We analyzed 215 patients undergoing burr hole drainage for 261 cSDHs in terms of preoperative comorbidities and postoperative drain placement.
  
  
  RESULTS
  Recurrences requiring repeat evacuation occurred in 6.1% overall, in 6/110 patients (5.5%) with 1 burr hole, and in 11/151 patients (7.3%) who had 2 burr holes, which was not significantly different. Recurrences occurred in 1/15 patients (6.7%) with no drain, 13/210 patients (6.2%) with 1 drain, and in 2/36 patients (5.6%) with 2 drains, which was also not statistically significant. The only medical comorbidity associated with an increased risk of recurrence was liver disease (P = 0.014).
  
  
  CONCLUSIONS
  This study demonstrates that neither the number of burr holes nor the number of drains left after a burr hole drainage of cSDH appear to affect recurrence rates, whereas liver disease does make recurrence more likely.
authors: Department of Neurosurgery, University of Miami, Jackson Memorial Hospital, Miami, Florida, USA. Electronic address: Joanna.gernsback@jhsmiami.org.
authors: Joanna
authors: J
authors: Gernsback
authors: Department of Neurosurgery, University of Miami, Jackson Memorial Hospital, Miami, Florida, USA.
authors: John Paul George
authors: JP
authors: Kolcun
authors: Department of Neurosurgery, University of Miami, Jackson Memorial Hospital, Miami, Florida, USA.
authors: Jonathan
authors: J
authors: Jagid
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004322:Drainage / Q000379:methods*; D005260:Female; D020200:Hematoma, Subdural, Chronic / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D014207:Trephining / Q000379:methods
keywords: Burr hole; Chronic subdural hematoma; Drain; Recurrence