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Dexamethasone and Statins in Patients Undergoing Primary Middle Meningeal Artery Embolization for Chronic Subdural Hematoma: A Propensity-Matched Study in the TriNetX Research Network.
- Source :
-
World neurosurgery [World Neurosurg] 2023 Aug; Vol. 176, pp. e83-e90. Date of Electronic Publication: 2023 May 08. - Publication Year :
- 2023
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Abstract
- Objective: Middle meningeal artery embolization (MMAE) is an effective minimally invasive option for chronic subdural hematoma (cSDH). Dexamethasone and statins have been reported to improve the resolution of cSDH and reduce its recurrence. However, only 1 study has investigated the role of statins in patients treated with MMAE, and there is no such study on dexamethasone. Thus, we used the TriNetX research network to determine whether adding dexamethasone or statin along with primary MMAE is associated with a benefit in outcomes.<br />Methods: We queried all primary MMAE cases for cSDH between January 1st, 2012, and July 1st, 2022, in the TriNetX research network. We included patients greater than or equal to 18 years old and separated them regarding statin and dexamethasone use around the time of MMAE. Outcomes were evaluated within 6 months and 3 years after MMAE, and analyses were performed before and after propensity score matching.<br />Results: The study included 372 patients with chronic subdural hematoma who underwent MMAE and were on dexamethasone, 339 not on dexamethasone, 391 on statins, and 278 not on statins. After propensity score matching, the dexamethasone cohorts included 250 patients each and only headache remained more prevalent in the dexamethasone cohort at both 6 months (21.2% vs. 10.0%, P = 0.001) and 3 years (23.6% vs. 12.4%, P = 0.001). After propensity score matching, the statin cohorts included 150 patients each and no differences in outcomes were found at both 6 months and 3 months after MMAE.<br />Conclusions: Patients treated with primary MMAE and were on dexamethasone or statins had no differences in mortality and functional/provider dependence compared to those who were not on dexamethasone or statins. Patients on dexamethasone had a higher prevalence of headaches.<br /> (Copyright © 2023. Published by Elsevier Inc.)
- Subjects :
- Humans
Meningeal Arteries diagnostic imaging
Meningeal Arteries surgery
Headache etiology
Dexamethasone therapeutic use
Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
Hematoma, Subdural, Chronic drug therapy
Hematoma, Subdural, Chronic etiology
Embolization, Therapeutic adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 176
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 37164211
- Full Text :
- https://doi.org/10.1016/j.wneu.2023.04.127