{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:37:47Z","timestamp":1791859067688,"version":"4.3.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Chronic subdural hematoma (CSDH) is a common condition among older people living with frailty. Outcome after surgery is generally good, but there is a significant proportion of patients who do not benefit from surgery. This study aimed to identify predictors of failure to improve functional outcomes after CSDH surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a post-hoc analysis of the nationwide FINISH trial, which enrolled 589 adult patients undergoing burr-hole drainage for symptomatic CSDH during 2020\u201322. Functional outcome was assessed using the modified Rankin Scale (mRS). Failure to improve was defined as unchanged or worsened mRS at 6\u00a0months compared to preoperative mRS. Multivariable logistic regression was used to identify factors associated with failure to improve.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 568 patients with available mRS data at 6\u00a0months, 20% (n\u2009=\u2009115) showed no improvement in mRS between the preoperative and 6-month period. Factors associated with failure to improve included pre-existing dementia (OR 2.62, 95% CI 1.21\u20135.66), use of a walker (OR 3.19, 95% CI 1.64\u20136.23), smaller hematoma width (OR 0.96, 95% CI 0.93\u20130.99), and lesser midline shift (OR 0.91, 95% CI 0.86\u20130.97). Despite this, 88% of patients had stable or improved residence status, and 85% maintained or improved mobility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A substantial proportion of surgically treated CSDH patients do not improve in functional status. Dementia was a significant predictor of poor outcomes. Future research should focus to better identify patients at risk of poor outcomes in order to avoid overtreatment and explore possible alternative treatment strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaf056","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T03:37:51Z","timestamp":1742182671000},"source":"Crossref","is-referenced-by-count":8,"title":["Failure to improve\u2014identifying risk factors for poor functional recovery following chronic subdural hematoma surgery"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4243-9591","authenticated-orcid":false,"given":"Rahul","family":"Raj","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Helsinki University Hospital and University of Helsinki , Helsinki Uusimaa 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