Clinical neurology and neurosurgery · 2025
Impact of adjunctive steroids on chronic subdural hematoma treated with surgery and MMAE: A propensity-matched study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Thakur Vishal V, McClure Jesse, Fletcher David, Melancon-Ricaurte Emily, Wilson Luke, Miller Dayton, McGaughey Tyler, Gandhi Dheeraj, Chen Huanwen, Colasurdo Marco, Ranjan Manish, Brandmeir Nicholas, Bhatia Sanjay, Lakhani Dhairya A
Аннотация
BACKGROUND: The impact of steroid use in patients with chronic subdural hematoma (cSDH) treated with both surgical evacuation and middle meningeal artery embolization (MMAE) has not been previously reported. This study compares outcomes in this specific patient population.
METHODS: We conducted a multi-institutional, multi-national, retrospective, propensity score-matched study using the TriNetX platform. Patients with cSDH who underwent both surgical evacuation and MMAE were included and stratified based on whether they received adjunctive steroid therapy. Primary outcomes included unplanned inpatient readmissions, need for repeat surgery, and six-month mortality.
RESULTS: A total of 605 cSDH patients met the inclusion criteria, of whom 283 received adjunctive steroids. After propensity score matching, no significant differences were observed in the primary outcomes between patients who received steroids and those who did not. However, the steroid group exhibited non-significantly higher rates of inpatient readmission and mortality.
CONCLUSION: In patients with cSDH treated with a combination of surgical evacuation and MMAE, adjunctive steroid therapy was not associated with improved outcomes. These findings suggest that steroids may not confer a clear benefit in this setting and could potentially expose patients to unnecessary risks.
METHODS: We conducted a multi-institutional, multi-national, retrospective, propensity score-matched study using the TriNetX platform. Patients with cSDH who underwent both surgical evacuation and MMAE were included and stratified based on whether they received adjunctive steroid therapy. Primary outcomes included unplanned inpatient readmissions, need for repeat surgery, and six-month mortality.
RESULTS: A total of 605 cSDH patients met the inclusion criteria, of whom 283 received adjunctive steroids. After propensity score matching, no significant differences were observed in the primary outcomes between patients who received steroids and those who did not. However, the steroid group exhibited non-significantly higher rates of inpatient readmission and mortality.
CONCLUSION: In patients with cSDH treated with a combination of surgical evacuation and MMAE, adjunctive steroid therapy was not associated with improved outcomes. These findings suggest that steroids may not confer a clear benefit in this setting and could potentially expose patients to unnecessary risks.