Determinants and outcomes in relation to day of ambulation following evacuation of chronic subdural haematoma
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Abstract
Background: Burr hole evacuation remains a widely accepted and effective treatment for chronic subdural haematoma (CSDH). Historically, patients are nursed in the supine position during the immediate postoperative period and mobilised later. The determinants of the timing of ambulation, and its relationship with recurrence and clinical outcomes, remain inadequately characterised in our setting. This study aimed to evaluate the factors influencing the day of ambulation and to examine its association with outcomes following burr-hole evacuation of chronic subdural haematoma.
Methods: We retrospectively assessed all patients who underwent burrhole evacuation of CSDH over 19 years. Data was obtained from a computerised log of patients' records, categorised based on the day of ambulation and outcomes were documented in terms of absence or presence of complications.
Results: Among 150 patients studied, there was no significant difference in demography between the different ambulation groups. The mean age was 60.28 years, and the male-to-female ratio was 4.2:1. Haematoma location, volume, brain expansion, and presence of membranes did not significantly impact the day of ambulation. Recurrence and wound breakdown were observed to be more in patients who were ambulated ≥7 days post op. One patient died.
Conclusion: The determinants of the day of ambulation include preoperative neurological status, age, comorbid conditions, postoperative complications, and institutional protocol. Ambulating patients 48 hours postoperatively appears safe with low recurrence.
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