Effect of Steroids as an Adjunct to Surgical Treatment in Patients with Chronic Subdural Hematoma

Roger Lodewijkx*, Dana Catharina Holl, Kari Anne Mariam Slot, Victor Volovici, Clemens Maria Franciscus Dirven, Ruben Dammers, William Peter Vandertop, Dagmar Verbaan

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)


The role of steroids as an adjunct to surgery for chronic subdural hematoma (cSDH) remains unclear. We evaluated the effect of steroids as an adjunct to surgery on recurrence rates, complications, and mortality. We retrospectively collected data of 525 patients operated on for cSDH between January 2010 and April 2015 at the Amsterdam University Medical Centers and Erasmus Medical Center Rotterdam. Data from patients with and without steroid use as an adjunct to surgery were obtained from medical records and compared using the chi-square test, independent-samples t-test, and Mann-Whitney U test, where applicable. Associations between adjuvant steroid use and complications were analyzed with univariable (penalized likelihood) logistic regression analysis. Multi-variate logistic regression was performed to analyze the influence of adjuvant steroid use on recurrence. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Two hundred seventy-eight of the 525 patients (53%) were treated with adjuvant steroids. Surgery for recurrences occurred less in patients of the steroid group (9% vs. 14%; odds ratio [OR] 0.57; 95% confidence interval [CI], 0.33-0.99), but the effect was not significant after correction for confounders (adjusted aOR, 0.59; 95% CI, 0.33-1.05). In the steroid group, delirium (10% vs. 3%; OR, 3.99; 95% CI, 1.72-9.29) and dysregulated glucose levels occurred more frequently (2% vs. 0%; OR, 11.81; 95% CI, 1.38-1542.79), but multi-variate analysis was not possible. After propensity-score matching, McNemar's chi-square test showed that adjuvant steroid use was not significantly associated with recurrence rate (p = 0.10). Steroids as an adjunct to surgery in patients with cSDH did not have a favorable effect on the recurrence rate in our data after controlling for confounders.

Original languageEnglish
Pages (from-to)2572-2579
Number of pages8
JournalJournal of Neurotrauma
Issue number18
Publication statusPublished - 15 Sept 2021

Bibliographical note

Publisher Copyright:
© Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.


Dive into the research topics of 'Effect of Steroids as an Adjunct to Surgical Treatment in Patients with Chronic Subdural Hematoma'. Together they form a unique fingerprint.

Cite this