{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T23:44:43Z","timestamp":1777765483178,"version":"3.51.4"},"reference-count":15,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Chronic subdural hematoma (CSDH) is a complex disease with an overall incidence of 1.7\u201320.6 per 100,000 persons per year and is more commonly encountered in the elderly population. It is projected to be one of the most common neurosurgical procedures. Postoperative delirium is a common complication associated with the elderly, causing increased morbidity and prolonged hospital stay. However, its risk factors in chronic subdural hematoma patients have not been well studied. Methods: A total of 202 consecutive patients with chronic subdural hematoma at different neurosurgical centers in Europe between January 2023 and June 2025 were enrolled. Various clinical indicators were analyzed to identify independent risk factors for postoperative delirium using univariate and multivariate regression analyses. Results: Out of the 202 patients (age, 71 (IQR, 18); female-to-male ratio, 1:2.7) studied, 63 (31.2%) experienced postoperative delirium. Univariate analysis identified age (p &lt; 0.001), gender (p = 0.014), restraint belt use (p &lt; 0.001), electrolyte imbalance (p &lt; 0.001), visual analog scale (VAS) pain score (p &lt; 0.001), hematoma thickness (p &lt; 0.001), midline shift (p &lt; 0.001), hematoma side (p = 0.013), hematoma location (p = 0.018), and urinal catheterization (p = 0.028) as significant factors. Multivariate regression analysis confirmed the significance of restraint belt use (B = 7.657, p &lt; 0.001), electrolyte imbalance (B = \u22123.993, p = 0.001), VAS pain score (B = 2.331, p = 0.016), and midline shift (B = 0.335, p = 0.007). Hematoma thickness and age had no significant impact. Conclusions: Increased midline shift and VAS pain scores, alongside restraint belt use and electrolyte imbalance, elevate delirium risk in chronic subdural hematoma surgery. Our prediction models may offer a reference value in this context.<\/jats:p>","DOI":"10.3390\/jcm15093412","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:01:18Z","timestamp":1777474878000},"page":"3412","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Factors in Development of Postoperative Delirium in Chronic Subdural Hematomas: A Prospective Multicenter Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3506-4111","authenticated-orcid":false,"given":"Ismail","family":"Zaed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland"},{"name":"Department of NESMOS, Sapienza University, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Chibbaro","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Medical and Surgical Sciences and Neurosciences, Siena University Hospital, Azienda Ospedaliera-Universitaria, 53100 Siena, Italy"},{"name":"Department of Neurosurgery, Hautepierre Hospital, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6532-7168","authenticated-orcid":false,"given":"Francesco","family":"Marchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5110-8386","authenticated-orcid":false,"given":"Luca","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Department of NESMOS, Sapienza University, 00185 Rome, Italy"},{"name":"UOC di Neurochirurgia, Azienda Ospedaliera Universitaria Sant\u2019Andrea, Dipartimento NESMOS, Sapienza Universit\u00e0 di Roma, 00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7237-633X","authenticated-orcid":false,"given":"Leonardo","family":"Di Cosmo","sequence":"additional","affiliation":[{"name":"School of Medicine, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles Henry","family":"Mallereau","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hautepierre Hospital, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Dannhoff","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hautepierre Hospital, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Todeschi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hautepierre Hospital, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8676-1147","authenticated-orcid":false,"given":"Mario","family":"Ganau","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2430-9558","authenticated-orcid":false,"given":"Davide","family":"Milani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7349-3753","authenticated-orcid":false,"given":"Andrea","family":"Cardia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1089\/neu.2023.29137.fs","article-title":"Neurotrauma Care: A Worldwide Perspective","volume":"40","author":"Servadei","year":"2023","journal-title":"J. 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