Study On The Relationship Between The Horizontal Changes Of Hospitalized Serum FDP And D-dimer And The Recurrence Of Chronic Subdural Hematoma

Objective: To investigate the relationship between serum FDP and D-dimer levels in patients with chronic subdural hematoma and their recurrence.Methods: Patients who were hospitalized for the first drilling hematoma removal and subdural catheterization treatment in CSDH patients in the Neurosurgery Department of Qinghai University Affiliated Hospital from August 2019 to February 2022 and accurately followed up for 90 days were selected as research subjects to include 180 cases.Taking the normal range of serum coagulation function detection in the Affiliated Hospital of Qinghai University as a reference,patients were divided into two groups:Serum FDP>5mg/L&DD>1mg/L(simultaneous elevated group)and serum FDP≤5mg/L&DD≤1mg/L or DD>1mg/L(FDP normal and DD normal or elevated group).Compare the recurrence rate of CSDH in the two groups within 90 days after the first operation,and compare whether there is a significant difference in the recurrence rate of CSDH in the two groups within 30 days after the first operation.Computed tomography was used for all diagnosis,and patients were treated with drilling closed drainage and subdural catheterization during the first operation.After 90 days of follow-up,recurrence is defined as re-expansion of hematoma with neurological symptoms such as headache,gait disorder or hemiplegia that need to be re-operation within 90 days after the initial operation,and the postoperative recurrence is assessed in combination with CT scan of the skull and the size and midline displacement of the patient’skull MRI examination.Results: The recurrence rate of FDP>5mg/L&DD>1mg/L group in CSDH patients is significantly higher than that in FDP≤5mg/L&DD≤1mg/L or DD>1mg/L(28.8% and9.9% respectively;P=0.005).The short-term postoperative recurrence rate of FDP>5mg/L&DD>1mg/L is also significantly higher than that of FDP≤5mg/L&DD≤1mg/L or DD>1mg/L(16.9% and 3.3% respectively;P=0.007).In contrast,there is no difference in long-term(31-90 days after surgery)recurrence rates(11.9 percent and 6.6% respectively;P=0.348;Table 4).FDP>5mg/L&DD>1mg/L(OR,4.898;95% confidence interval,1.439-16.677;P=0.011)shows a significant correlation with possible recurrence of CSDH and is an independent predictor of recurrence within90 days.Conclusion: 1.Simultaneous increase of serum FDP&DD at admission may be a new predictor of CSDH recurrence.In particular,in this population,the patient should consider recurrence within 30 days after surgery;2.After drilling and drainage,the recurrence rate of the older CSDH patients(≥80 years old)is relatively high;the recurrence rate of CSDH patients with bilateral hematoma is relatively high.