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Validierung und Entwicklung von Modellen für die Vorhersage des klinischen Behandlungsergebnisses bei älteren Patient:innen mit chronischen Subduralhämatomen

dc.contributor.advisorvon der Brelie, Christian PD Dr.
dc.contributor.authorHernandez Duran, Silvia
dc.date.accessioned2022-12-15T10:56:49Z
dc.date.available2022-12-22T00:50:10Z
dc.date.issued2022-12-15
dc.identifier.urihttp://resolver.sub.uni-goettingen.de/purl?ediss-11858/14418
dc.identifier.urihttp://dx.doi.org/10.53846/goediss-9634
dc.format.extent37de
dc.language.isodeude
dc.subject.ddc610de
dc.titleValidierung und Entwicklung von Modellen für die Vorhersage des klinischen Behandlungsergebnisses bei älteren Patient:innen mit chronischen Subduralhämatomende
dc.typedoctoralThesisde
dc.contributor.refereeBehme, Daniel PD Dr.
dc.date.examination2022-12-15de
dc.description.abstractengBackground: The Subdural Hematoma in the Elderly (SHE) score was developed as a model to predict 30-day mortality from acute, chronic and mixed subdural hematoma in the elderly population after minor or no trauma. Emerging evidence suggests frailty to be predictive of mortality and morbidity in the elderly. In this study, we aim to externally validate the SHE for chronic subdural hematoma (CSDH) alone, and we hypothesize that the incorporation of frailty into the SHE may increase its predictive power. Methods: A retrospective cohort of elderly patients with CSDH after minor or no trauma being treated at our institution were evaluated with the SHE. 30-day mortality and outcome were documented. Patients were assessed with the Clinical Frailty Scale (CFS), which was incorporated into a modified SHE (mSHE). Both the SHE and the mSHE were then assessed in their predictive powers through receiver operating characteristic statistics. Results: We included 168 patients. Most (n=124, 74%) had a favorable outcome at 30 days. Mortality was low at n=7, 4%. The SHE failed to predict mortality (AUC=.564, p=.565). Contrarily, the mSHE performed well in both mortality (AUC=.749, p=.026) and outcome (AUC=.862, p<.001). A threshold of mSHE=3 is predictive of mortality with a sensitivity of 50% and a specificity of 75%; and of poor outcome with a sensitivity of 88% and a specificity of 64%. Conclusion: Frailty should be routinely evaluated in elderly individuals, as it can predict outcome and mortality, providing the possibility for a medical, surgical, nutritional, cognitive and physical exercise interventions.de
dc.contributor.coRefereeWasser, Katrin PD Dr.
dc.subject.engChronic subdural hematomade
dc.subject.engelderlyde
dc.subject.engfrailtyde
dc.identifier.urnurn:nbn:de:gbv:7-ediss-14418-9
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullNeurologie - Allgemein- und Gesamtdarstellungen (PPN619876247)de
dc.description.embargoed2022-12-22de
dc.identifier.ppn1827567104
dc.notes.confirmationsentConfirmation sent 2022-12-15T11:15:01de


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