Social Determinants of Health and Long-Term Mortality of Patients with Chronic Subdural Hematoma: Is There an Association?

(1) Background: A chronic subdural hematoma (CSDH) is considered an acute life-threatening event that is easily treated surgically, but little is known about the longer-term mortality of these patients. The objective of this study was to evaluate the association of social determinants of health (SDoH) and the long-term mortality of patients with a chronic subdural hematoma. (2) Methods: This retrospective cohort study included 121 (88 male and 33 female) patients with a surgically treated unilateral or bilateral CSDH. Mortality was evaluated at 1, 2, 6, and 12 months after treatment. (3) Results: Most of the patients were >65 and retired, N = 96 (79.3%); of them, the majority presented with a neurological deficit, N = 71 (73.9%). Patients who lived alone more often had a neurological deficit, N = 57 (75.0%), compared to those who lived in communities, N = 25 (55.5%). Mortality at 1, 2, 6, and 12 months after surgery was 10.7%, 17.4%, 19.0%, and 45.5%, respectively, and there was a significant difference in the median age between the survival and deceased groups at 1 month (<i>p</i> < 0.01), 2 months (<i>p</i> < 0.01), and 6 months (<i>p</i> < 0.01) of follow-up, but not in the long-term (12 months) follow-up (<i>p</i> = 0.200). Patients who lived alone had 3.7 times higher odds of dying at the 12-month follow-up (<i>p</i> < 0.01), compared to those who lived in the community. (4) Conclusions: Living alone is related to an increased case fatality risk after CSDH surgery in the Serbian context. Social determinants of health can be associated with CSDH presentation and survival, indicating that further studies should include SDoH to obtain a deeper understanding of the occurrence, presentation, and outcomes of SDoH and propose additional preventive measures.

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Journal
Healthcare
Published
2024-08-15
DOI
https://doi.org/10.3390/healthcare12161627
Primary Topic
Neurosurgical Procedures and Complications
Type
article
Field-Weighted Citation Impact
0.00

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article

Social Determinants of Health and Long-Term Mortality of Patients with Chronic Subdural Hematoma: Is There an Association?

Sanja Lepić, Milan Lepić, Aleksa Mićić, Stefan Mandić‐Rajčević et al.
Healthcare
Neurosurgical Procedures and Complications
article

Social Determinants of Health and Long-Term Mortality of Patients with Chronic Subdural Hematoma: Is There an Association?

Sanja Lepić, Milan Lepić, Aleksa Mićić, Stefan Mandić‐Rajčević, Lukas Rasulić
article en

Abstract

(1) Background: A chronic subdural hematoma (CSDH) is considered an acute life-threatening event that is easily treated surgically, but little is known about the longer-term mortality of these patients. The objective of this study was to evaluate the association of social determinants of health (SDoH) and the long-term mortality of patients with a chronic subdural hematoma. (2) Methods: This retrospective cohort study included 121 (88 male and 33 female) patients with a surgically treated unilateral or bilateral CSDH. Mortality was evaluated at 1, 2, 6, and 12 months after treatment. (3) Results: Most of the patients were >65 and retired, N = 96 (79.3%); of them, the majority presented with a neurological deficit, N = 71 (73.9%). Patients who lived alone more often had a neurological deficit, N = 57 (75.0%), compared to those who lived in communities, N = 25 (55.5%). Mortality at 1, 2, 6, and 12 months after surgery was 10.7%, 17.4%, 19.0%, and 45.5%, respectively, and there was a significant difference in the median age between the survival and deceased groups at 1 month (<i>p</i> < 0.01), 2 months (<i>p</i> < 0.01), and 6 months (<i>p</i> < 0.01) of follow-up, but not in the long-term (12 months) follow-up (<i>p</i> = 0.200). Patients who lived alone had 3.7 times higher odds of dying at the 12-month follow-up (<i>p</i> < 0.01), compared to those who lived in the community. (4) Conclusions: Living alone is related to an increased case fatality risk after CSDH surgery in the Serbian context. Social determinants of health can be associated with CSDH presentation and survival, indicating that further studies should include SDoH to obtain a deeper understanding of the occurrence, presentation, and outcomes of SDoH and propose additional preventive measures.

HealthcareVol. 12(16)
Military Medical Academy (RS), University of Belgrade (RS), University of Defence (RS)
Academy of Military Medical Sciences
Good health and well-being
Openalex Percentile: Top 79%
Neurosurgical Procedures and Complications
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