J Korean Neurotraumatol Soc.  2010 Jun;6(1):48-52. 10.13004/jknts.2010.6.1.48.

The Effect of Early Mobilization for the Patients of Chronic Subdural Hematoma after Closed Drainage Surgery

• Oh JW
• Whang K
• Pyen JS
• Jung HH

• KMID: 2192365
• DOI: http://doi.org/10.13004/jknts.2010.6.1.48

Abstract

OBJECTIVE
The purpose of this study is to evaluate the effect of early mobilization for the patients of chronic subdural hematoma after closed drainage.
METHODS
From May 2007 to March 2010, 58 patients with the chronic subdural hematoma treated by closed drainage surgery were included for this study. They were divided into early (EM) and delayed mobilization (DeM) group. We defined the EM group as not only an upright position but also ambulation at the day of operation. And then we evaluated the reoperation rates, duration of hospitalization, cost, postoperative subdural space and complications in each groups.
RESULTS
Among 58 patients, 15 were EM and the others, 43, were DeM. Duration of hospitalization for EM was shorter than that for DeM about 12days (p=0.006). Reoperation rates in EM was 13% and that for DeM was 22%, but it did not show significant difference (p=0.336). Medical cost of DeM was higher than EM. Postoperative subdural space of EM was 10.03 mm, and that of DeM 10.24 mm, which did not showed any significance. And complications, such as pneumonia, ulcer, deep vein thrombosis, were developed in DeM.
CONCLUSION
EM after closed drainage for chronic subdural hematoma patients showed shorter duration of hospitalization than DeM, also lower cost and fewer complications. And there were no difference between two groups in reoperation rates. EM was better postoperative management methods than DeM after closed drainage.

Keyword

Early mobilization; Delayed mobilization; Chronic subdural hematoma

MeSH Terms

Drainage
Early Ambulation
Hematoma, Subdural, Chronic
Hospitalization
Humans
Pneumonia
Reoperation
Subdural Space
Ulcer
Venous Thrombosis
Walking

Figure

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  FIGURE 1 Duration of hospitalization of EM and DeM. Duration of hospitalization for EM was shorter than that for DeM (p=0.0006). EM: early mobilization group, DeM: delayed mobilization group.

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  FIGURE 2 Reoperation rates of EM and DeM. Reoperation rates of DeM were higher than EM. But it was not statistically significant (p=0.336). EM: early mobilization group, DeM: delayed mobilization group.

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  FIGURE 3 Postoperative subdural space in EM and DeM. In DeM group, there were slightly more increased subdural space, but not statistically significant (p=0.8542). EM: early mobilization group, DeM: delayed mobilization group.

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  FIGURE 4 This brain computer tomography (CT) was from 75 year-old male patient with chronic renal failure. A: Preoperative CT showed chronic subdural hematoma on left hemisphere. B: Postoperative CT scan on 2nd day, chronic subdural hematoma was almost drained out, but intracerebral hemorrhage was newly developed.

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