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This post hoc analysis of the nationwide, multicentre, randomized FINISH trial examined whether a residual chronic subdural hematoma thickness of ≥10 mm at 6 weeks after burr-hole drainage is clinically meaningful. Among 581 patients (median age 78 years), 283 (49%) had a residual thickness of ≥10 mm. This was associated with worse mRS scores at 6 weeks (adjusted OR 1.6, 95% CI 1.2–2.2; P=0.004) and 6 months (aOR 1.4, 95% CI 1.0–1.8; P=0.049), but not with unfavourable outcome (mRS 4–6) at 6 months (aOR 1.3, 95% CI 0.7–2.4; P=0.48). Reoperation within 6 months occurred in 16% overall: 32% in the ≥10 mm group versus 0.7% in the <10 mm group (aOR 75.6, 95% CI 18.0–316.8; P<0.001). Because the relationship between thickness and outcome appeared linear, any single cut-off is arbitrary; the authors suggest the 10 mm threshold may serve as a surrogate trial endpoint alongside patient-centred outcomes.
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This post hoc analysis of the nationwide, multicentre, randomized FINISH trial examined whether a residual chronic subdural hematoma thickness of ≥10 mm at 6 weeks after burr-hole drainage is clinically meaningful. Among 581 patients (median age 78 years), 283 (49%) had a residual thickness of ≥10 mm. This was associated with worse mRS scores at 6 weeks (adjusted OR 1.6, 95% CI 1.2–2.2; P=0.004) and 6 months (aOR 1.4, 95% CI 1.0–1.8; P=0.049), but not with unfavourable outcome (mRS 4–6) at 6 months (aOR 1.3, 95% CI 0.7–2.4; P=0.48). Reoperation within 6 months occurred in 16% overall: 32% in the ≥10 mm group versus 0.7% in the <10 mm group (aOR 75.6, 95% CI 18.0–316.8; P<0.001). Because the relationship between thickness and outcome appeared linear, any single cut-off is arbitrary; the authors suggest the 10 mm threshold may serve as a surrogate trial endpoint alongside patient-centred outcomes.
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