National Chronic Subdural Haematoma (CSDH) Audit

Trainee Lead Investigators: Paul Brennan (Edinburgh) and Ian Coulter (Middlesbrough)
Consultant Lead: Peter Hutchinson (Cambridge)



Background

Chronic subdural haematoma (CSDH) is a common condition and increases in incidence with rising age.  Evacuation of a CSDH is one of the commonest neurosurgical procedures; however the optimal peri-operative management, surgical technique, postoperative care and the role of adjuvant therapies remains controversial.


Objectives

We propose a prospective multi-centre audit in order to establish current practices, outcomes and national benchmarks for future studies.


Methods

Neurosurgical units (NSU) in the United Kingdom and Ireland will be invited to recruit patients to this audit.  Eligible patients will be identified by neurosurgical staff on the basis of the following inclusion criteria: adults aged 16 years or over; any patient with a primary or recurrent CSDH confirmed on cranial imaging treated at a participating NSU


Outcome measures and analysis

The proposed outcome measures are: (1) clinical recurrence requiring re-operation within 60 days; (2) modified Rankin scale (mRS) score at discharge from NSU; (3) mortality and morbidity in the NSU; (4) destination at discharge from NSU; (5) length of stay in the NSU. Audit standards have been derived from published systematic reviews and a recent randomised trial.  The proposed standards are: clinical recurrence rate <20%; unfavourable mRS (4-6) at discharge from NSU <30%; mortality rate in NSU <5%; morbidity rate in NSU <10%.  Data will be entered into a secure online database and analysed by the study’s steering committee. 


Conclusions

The audit aims to describe contemporary current practice patterns and outcomes of patients with CSDH in the United Kingdom and Ireland.  This audit will pave the way for future studies that will better inform national guidelines and practice in order to improve the outcome of patients with CSDH.


Data collection

This audit has now closed its data collection. 

Published outcomes

Data analysis is still underway. Manuscripts are planned for submission in the near future.  




Important Documents
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Aimun Jamjoom,
May 8, 2013, 2:35 PM