Age-related tolerability of hard-channel puncture and drainage for chronic subdural hematoma: A single-center retrospective study

Chronic subdural hematoma predominantly occurs in the elderly population; however, this study includes patients across all age groups. Age was analyzed as a continuous variable to evaluate its effect on the tolerability of hard-channel therapy in elderly patients. We retrospectively analyzed 191 chronic subdural hematoma patients treated with hard-channel therapy from December 2016 to March 2023. Age was treated as a continuous variable to assess its association with mortality, surgery-related complications, recurrence, functional outcomes, and hospital stay length. This study aimed to assess the age-related tolerability of hard-channel therapy for chronic subdural hematoma, focusing particularly on elderly patients. Among 191 patients with chronic subdural hematoma treated by hard-channel therapy, the median age was 75 years. Age was significantly associated with increased mortality (odds ratio 1.14, P = .020) and poorer functional recovery measured by mRS (β = 0.02, P = .009). No significant associations were found between age and complication rates, recurrence, or hospital stay duration. Preoperative Barthel Index independently predicted mortality risk after adjustment. Comorbidity burden was correlated with worse functional outcomes. Age was significantly associated with adverse postoperative outcomes in univariate analysis, but this effect was attenuated after adjustment for functional status and comorbidities. This suggests age mainly reflects cumulative comorbidity and functional impairment. Incorporating these factors into risk models is essential for evaluating elderly patients undergoing hard-channel therapy.