Coagulopathy and outcome in patients with chronic subdural haematoma

Objective– The coincidence of coagulatopathy and chronic subdural haematoma (CSH) requires correction of coagulation to facilitate surgery. We investigated the correlation between coagulopathy and outcome in CSH patients. Material and methods– We analysed past medical history, surgical treatment and coagulation parameters of 114 patients. Results– Coagulation disorders were found in 42%. Preoperative treatment with prothrombin complex concentrate was necessary in 14%. A significant difference (P < 0.05) of the preoperative level of platelets was found between recurrent CSH and non‐recurrent group. Totally, we had to perform re‐operations in 17.5%. Eighty‐one patients presented with Glasgow coma scale (GCS) ≥ 13. After surgery GCS was ≥ 13 in n = 92. There was an improvement of GCS in 46 cases, 61 patients maintained GCS score levels. Outcome was significantly worse in the alcoholic group (P < 0.001), and in the recurrent group (P < 0.05). In patients with substitution of coagulation factors, outcome was worse in the group with post‐operative substitution only (P < 0.05). Conclusion– In CSH, the coagulation parameters and a subtle correction of coagulation are of special interest, regarding the worse outcome in patients with recurrent CSH and in those requiring post‐operative substitution.