Development and Validation of the Chronic Subdural HematOma Referral oUtcome Prediction Using Statistics (CHORUS) Score: A Retrospective Study at a National Tertiary Center

• Published in: World neurosurgery 2023-02, Vol.170, p.e724-e736
• Main Authors: Biswas, Sayan, MacArthur, Joshua, Sarkar, Ved, Thompson, Helena, Saleemi, Mohammad, George, K. Joshi
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Chronic subdural hematoma; Decision making; Hematoma, Subdural, Chronic - diagnostic imaging; Hematoma, Subdural, Chronic - surgery; Humans; Prognosis; Quality of Life; Recurrence; Referral and Consultation; Referral prediction; Retrospective Studies; Scoring system
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2022.11.097

Chronic subdural hematoma (CSDH) is a common neurosurgical condition with an increasing rate of patient referrals. CSDH referral decision-making is a subjective clinical process, and our aim was to develop a simple scoring system capable of acting as a decision support tool aiding referral triage. A single tertiary center retrospective case series analysis of all CSDH patient referrals from 2015 to 2020 was conducted. Ten independent variables used in the referral process were analyzed to predict the binary outcome of either accepting or rejecting the CSDH referral. Following feature selection analysis, a multivariable scoring system was developed and evaluated. 1500 patient referrals were included. Stepwise multivariable logistic and least absolute shrinkage and selection operator regression identified age