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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(04): 707-714
DOI: 10.1055/s-0044-1789247
Original Article

Prediction of Postoperative Recurrence of Chronic Subdural Hematoma Using Preoperative Systemic Immune Inflammation Index and Eosinophils

Kumar Vaibhav 
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Anurag Sahu
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Ravi Shankar Prasad
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Debabrata Deb
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Devendra Kumar
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
,
Abjad Karimi
1   Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
› Author Affiliations Funding None.
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Abstract

Objective Chronic subdural hematoma (CSDH) is a common neurological problem with significant recurrence after surgery. Risk considerations can vary, ranging from patient-related factors to those related to the surgical procedure. This study explores the association between preoperative eosinophil count and systemic immune inflammation (SII) with CSDH recurrence.

Materials and Methods We conducted a prospective analysis of 105 patients with equal numbers of CSDHs who underwent surgery for CSDH between January 2023 and January 2024. The preoperative eosinophil counts, along with other differential leukocyte counts, were measured. The SII index was calculated using the standard formula (SII = neutrophil count  ×  platelet count/lymphocyte count). Multivariate and univariate regression analyses were performed to assess the association between risk factors and CSDH recurrence.

Results The preoperative eosinophil count showed a significant correlation with recurrence (p < 0.001). The SII index was significantly higher in patients with recurrent CSDH (p = 0.003). Neutrophils were found to be significantly associated with CSDH recurrence (p = 0.038). Age (p < 0.001) and SII (p = 0.005) were found to be independent predictors of CSDH recurrence, whereas hematoma volume (p < 0.001) and the antiplatelet regimen were a significant predictor of CSDH recurrence (p = 0.047). Variables like male gender, diabetes mellitus, anticoagulants, and hematoma volume were associated with eosinophil-rich or eosinophil-poor status.

Conclusion Preoperative eosinophil count, neutrophils, and the SII index may serve as potential predictors of CSDH recurrence. Further studies with larger sample sizes are needed to validate these findings.

Keywords

chronic subdural hematoma - recurrence - eosinophils - systemic immune inflammation - predictors

Supplementary Material



Publication History

Article published online:
21 August 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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