{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:28:14Z","timestamp":1787228894563,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n Background:<\/jats:title>\n Chronic subdural hematoma (CSDH) is increasingly common in older adults. Although burr-hole evacuation is effective, outcome and recurrence remain variable. This study evaluated the predictors of outcome and recurrence after a uniform double burr-hole technique.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n In this prospective observational study, 101 symptomatic CSDH patients admitted to Dayanand Medical College and Hospital, Ludhiana (July 2023\u2013September 2024) underwent double burr-hole craniostomy with subdural drain. Demographic variables, comorbidities, antithrombotic use, alcohol intake, clinical status (Glasgow Coma Scale [GCS], Markwalder grade, and modified Rankin scale mRS), CT findings (density, thickness, midline shift, laterality, membranes, and cerebral atrophy), laboratory parameters (international normalized ratio [INR], serum albumin, and total proteins), intraoperative findings, complications, recurrence, and hospital stay were recorded. Outcomes were assessed using the Glasgow Outcome Scale (GOS) at discharge and at 2 months and dichotomized as favorable (GOS 5) or unfavorable (GOS 1\u20134).<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The cohort was predominantly male (81.2%) and elderly. Favorable outcome was achieved in 78.2% at discharge and 84.2% at 2 months; recurrence occurred in 14.9%. Unfavorable discharge outcome was significantly associated with older age (\n P<\/jats:italic>\n = 0.027), hypertension (\n P<\/jats:italic>\n = 0.026), poorer neurological status (higher Markwalder grade, higher mRS, lower GCS; all\n P<\/jats:italic>\n < 0.001), bilateral hematoma (\n P<\/jats:italic>\n = 0.037), cerebral atrophy (\n P<\/jats:italic>\n = 0.021), intraoperative membranes (\n P<\/jats:italic>\n = 0.036), higher INR (\n P<\/jats:italic>\n = 0.047), and lower serum albumin (\n P<\/jats:italic>\n < 0.001) and total proteins (\n P<\/jats:italic>\n = 0.002). Hematoma thickness and midline shift were not predictive. Recurrence was significantly associated with hypertension (\n P<\/jats:italic>\n = 0.046), blood thinner use (\n P<\/jats:italic>\n = 0.001), alcohol consumption (\n P<\/jats:italic>\n < 0.001), and higher INR (\n P<\/jats:italic>\n = 0.007). Recurrence strongly predicted unfavorable follow-up outcome (\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n After uniform double burr-hole evacuation, outcome and recurrence in CSDH are primarily influenced by baseline neurological status, vascular comorbidity, cerebral atrophy, membrane formation, and coagulation\/nutritional markers, with antithrombotics and alcohol strongly increasing recurrence risk.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijabmr.ijabmr_48_26","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:00:51Z","timestamp":1787166051000},"page":"179-186","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Neurological Outcome and Recurrence after Standardized Double Burr-hole Evacuation for Chronic Subdural Hematoma"],"prefix":"10.4103","volume":"16","author":[{"given":"Saurabh","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Lakhanpal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagminder","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, 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