Aim:Coagulation dysfunction is associated with a risk of poor prognosis in patients with chronic subdural hematoma (CSDH). However, the association between thromboelastography (TEG) parameters and CSDH is unclear.
Material and Methods:A prospective pilot study was conducted on 52 patients with CSDH. The primary outcomes were CSDH severity, recurrence rate, and outcome. The secondary outcome was the association between TEG parameters and the risk factors of CSDH.
Results:The association between the preoperative TEG parameters and the primary outcomes was compared. Results revealed no statistically significant association between the primary outcomes and admission modified Rankin scale score and follow-up GOS score. The R values significantly differed between patients with recurrence and those without (p = 0.045). Further subgroup analysis of TEG parameters revealed that patients with R values ≥ 5 had a significantly high incidence of recurrence (1.231, 95% confidence interval [CI]: 0.9731.557], P = 0.025). However, further logistic regression analysis did not reveal significant results (1.198, 95% CI: 0.8551.680, P = 0.293). Moreover, the association between the preoperative TEG parameters and the secondary outcomes was compared. Results revealed a statistically significant association between the secondary outcomes and hematoma thickness and LY30 values (P = 0.039), midline shift and Angle (P = 0.043), and multiplicity of the hematoma cavity and MA (P = 0.022). Further, the secondary outcomes were also significantly associated with postoperative TEG parameters such as multiplicity of the hematoma cavity and LY 30 value (P = 0.011) and residual hematoma at follow-up (MA, P = 0.001).
Conclusion:Due to the small sample size, the efficacy of TEG parameters in predicting CSDH recurrence is unclear. However, TEG parameters are associated with the imaging characteristics of CSDH, and they can also be used to predict the absorption of hematoma. Nevertheless, large-scale prospective cohort studies should be performed to further validate the findings of this study.
