Impact of onset timing and operative duration on outcomes in chronic subdural hematoma: an exploratory retrospective study

By
Liang Wang
Jinjin Wang
Qingpeng Meng
May 7, 2026
0 min

Frontiers In Neurology

Overview

Revise to specify that 'improved' refers to statistically significant increases in functional scores.

Background

Chronic subdural hematoma (CSDH) is a common neurosurgical condition that can lead to significant morbidity. Surgical intervention is the primary treatment, yet outcomes can vary widely, influenced by factors such as surgical timing and duration. Understanding these factors is crucial for optimizing patient management and improving recovery rates.

Data Highlights

Measure	Duration > 60 min (n=99)	Duration ≤ 60 min	p-value
Postoperative GCS	Higher	Lower	0.022
Postoperative KPS	Higher	Lower	0.031
Postoperative mRS	No difference	No difference	0.149
Postoperative ECOG	No difference	No difference	0.077
Recurrence Rate	No difference	No difference	0.200
Complications	No difference	No difference	0.605

Key Findings

Surgical duration exceeding 60 minutes is associated with higher postoperative GCS and KPS scores.
No significant differences in mRS, ECOG scores, recurrence rates, or complications based on surgical duration.
Weak negative correlations exist between surgical duration and postoperative mRS and ECOG scores.
Postoperative KPS and GCS scores show weak positive correlations with surgical duration.
The interval from symptom onset to surgery is linked to longer hospital stays.
Statin usage does not significantly correlate with any outcome measures.

Clinical Implications

Surgeons may consider extending surgical duration beyond 60 minutes to potentially enhance postoperative functional outcomes in CSDH patients. However, the timing of surgery relative to symptom onset does not appear to significantly impact short-term recovery, suggesting flexibility in scheduling may be appropriate.

Conclusion

This exploratory analysis indicates that longer surgical durations may improve certain postoperative outcomes in CSDH patients, while the timing of surgery relative to symptom onset does not significantly influence recovery. Further research is needed to confirm these findings.