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All patients were followed until death or the end of 2017. Cumulative relative survival ratios and relative excess risks of death (RER) were estimated by comparing patients\u2019 mortality with that in the entire regional matched population. The causes of death were compared with a separate reference group formed by randomly choosing sex, age, and calendar time matched controls (4 controls per each CSDH patient).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The median follow-up time was 4.8\u00a0years (range\u2009=\u20090\u201327\u00a0years), and 710 (63%) of the patients died (median age at death\u2009=\u200984\u00a0years old). The cumulative excess mortality was 1\u00a0year\u2009=\u20099%, 5\u00a0years\u2009=\u200918%, 10\u00a0years\u2009=\u200927%, 15\u00a0years\u2009=\u200937%, and 20\u00a0years\u2009=\u200948%. A subgroup of CSDH patients (<jats:italic>n<\/jats:italic>\u2009=\u2009206) with no comorbidity had no excess mortality. Excess mortality was related to poor modified Rankin score at admission (RER\u2009=\u20094.93) and at discharge (RER\u2009=\u20098.31), alcohol abuse (RER\u2009=\u20094.47), warfarin (RER\u2009=\u20092.94), age\u2009\u2265\u200980\u00a0years old (RER\u2009=\u20091.83), non-operative treatment (RER\u2009=\u20091.56), and non-traumatic etiology (RER\u2009=\u20091.69). Hematoma characteristics or recurrence were unrelated to excess mortality. Dementia was the most common cause of death among the CSDH patients (21%) and the third most common cause in the reference group (15%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Patients with CSDH have continuous excess mortality up to 20\u00a0years after diagnosis. Patient-related characteristics have a strong association with excess mortality, whereas specific CSDH-related findings do not. CSDH patients have an increased risk for dementia-related mortality.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00701-020-04278-w","type":"journal-article","created":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T13:02:27Z","timestamp":1583586147000},"page":"1467-1478","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Long-term excess mortality after chronic subdural hematoma"],"prefix":"10.1007","volume":"162","author":[{"given":"Minna","family":"Rauhala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauli","family":"Hel\u00e9n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karri","family":"Sepp\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tero","family":"Niskakangas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"\u00d6hman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teemu M.","family":"Luoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,7]]},"reference":[{"key":"4278_CR1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1136\/pmj.78.916.71","volume":"78","author":"V Adhiyaman","year":"2002","unstructured":"Adhiyaman V, Asghar M, Ganeshram KN, Bhowmick BK (2002) Chronic subdural haematoma in the elderly. 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Dr. Iverson acknowledges unrestricted philanthropic support from the Mooney-Reed Charitable Foundation, Heinz Family Foundation, ImPACT Applications, Inc., and Spaulding Research Institute. He serves as a strategic scientific advisor for BioDirection, Inc. The other authors report nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee (the Ethics Committee of the Pirkanmaa Hospital District, approval code R12082) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All data was collected retrospectively without contacting the patients. For this type of study formal consent is not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The sponsors had no role in the design or conduct of this research.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}