Choosing the best operation for chronic subdural hematoma: a decision analysis.
作者： Bradley C. Lega , Shabbar F. Danish , Neil R. Malhotra , Seema S. Sonnad , Sherman C. Stein
关键词: Therapeutic irrigation 、 Surgery 、 Decision analysis 、 Population 、 Health care 、 Comorbidity 、 Hematoma 、 Craniotomy 、 MEDLINE 、 Medicine 、 Emergency medicine
摘要: Object Chronic subdural hematoma (CSDH), a condition much more common in the elderly, presents an increasing challenge as population ages. Treatment strategies for CSDH include bur-hole craniostomy (BHC), twist-drill (TDC), and craniotomy. Decision analysis was used to organize existing data develop recommendations effective treatment. Methods A Medline search identify articles about treatment of CSDH. Direct assessment by health care professionals relative impact complications recurrences generate utility values outcomes. Monte Carlo simulation sensitivity analyses allowed comparisons across strategies. second examined whether intraoperative irrigation or postoperative drainage affect outcomes following BHC. Results On scale from 0 1, BHC found be 0.9608, compared with 0.9202 TDC (p = 0.001) 0.9169 craniotomy 0.006). Sensitivity conf...
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