Association Between Postoperative Mini-Balance Evaluation Systems Test Scores and Length of Hospital Stay in Patients with Chronic Subdural Hematoma: A Prospective Cohort Study

Abstract

Objectives

Chronic subdural hematoma (CSDH) generally has favorable outcomes; however, some patients develop balance and gait impairments, leading to prolonged hospitalization. This study examined the association between Mini-Balance Evaluation Systems Test (Mini-BESTest) scores, and length of hospital stay (LOS) after CSDH surgery.

Methods

This prospective cohort study was conducted at a single acute care hospital in Japan. Patients aged ≥ 65 years who underwent burr-hole drainage for CSDH were included. Exclusion criteria were orthopedic disease, psychiatric disease, inability to complete the Mini-BESTest, and premorbid modified Rankin Scale ≥ 4. Variables included age, sex, initial National Institutes of Health Stroke Scale, Glasgow Coma Scale, Mini-Mental State Examination–Japanese, residual hematoma thickness, premorbid modified Rankin Scale (mRS), Mini-BESTest score, and LOS. Spearman correlation and multivariable linear regression analyses were performed.

Results

Of 49 patients, 32 were analyzed after exclusions due to comorbidities, inability to complete the assessment, or premorbid disability. Twenty-five patients were men and the mean age was 81.8 ± 5.0 years. The median LOS was 8.5 (interquartile range [IQR] 8–11) days, and the Mini-BESTest was 18.5 (IQR 13.8–23.3). LOS was negatively correlated with Mini-BESTest (r = −0.499) and positively with initial NIHSS (r = 0.376). In multivariable regression, Mini-BESTest (β = −0.488) and initial NIHSS (β = 0.377) scores were associated with LOS.

Conclusions

Early postoperative balance function may be associated with LOS in patients with CSDH. Early Mini-BESTest assessment may help identify patients at risk for prolonged hospitalization and guide rehabilitation and discharge planning.