Hospitals Unprepared for Surge in Subdural Hemorrhages

By 2030, chronic subdural hemorrhage rates will increase drastically, and hospitals may be unprepared.

Chronic subdural hemorrhage (SDH) will become the most prevalent condition requiring neurosurgical intervention by 2030, but researchers believe hospitals may not have the staff to accommodate these patients.

Researchers from New York University Langone Medical Center published the results of their study in the Journal of Neurosurgery.

SDH occurs more commonly in older adults due to increased brain atrophy, higher usage of anti-coagulant medications, and thinning of blood vessels on the brain’s surface. The researchers in this study wanted to determine the incidence of SDH from 2012 through 2040 as the population of the United States ages.

The researchers aimed to determine future incidence rates for both the general and U.S. Veterans Administration (VA) populations, because veterans have an increased risk for SDH. The researchers looked at SDH diagnosis data from VA hospitals. They also used SDH data from Finland and Japan because the United States does not have precise data on SDH incidence. Using this data, they created a mathematical model that took age, gender, and alcohol consumption into account to predict the U.S. incidence of SDH from 2012-2040.

The VA hospital records showed that 695 cases of SDH were diagnosed from 2000-2012, 29% of which required surgery. Taking the rest of the data into account, the researchers determined that over 70% of SDH cases occurred in people aged ≥65 years.

By 2030, the researchers believe that 25% of the population of the United States could be aged ≥65 years. Based on these numbers, their model predicts that rates of chronic SDH will reach 121.4 per 100,000 people in the VA population and 17.6 per 100,000 people in the general U.S. population. These numbers translate to approximately 60,000 new cases per year.

“In 15 years, drainage for SDH will likely be the most common type of adult brain surgery performed, surpassing the number of operations required for brain tumors,” said researcher Uzma Samadani, MD, PhD. “If we can identify patients at risk and prevent brain atrophy from occurring as Americans age, we may be able to slow this trend. If not, we are going to need increased neurosurgical and rehabilitation capacity to manage these patients.”

For more information about the report, go here.