Impact of Vitamin D Levels on Outcomes in Chronic Subdural Hematoma

Introduction: Chronic subdural hematoma (CSDH) is common in elderly patients and leads to significant morbidity and mortality. Vitamin D regulates calcium homeostasis, essential for neuromuscular function and bone health. Calcium's role in the coagulation cascade is important in CSDH, as dysregulation may influence bleeding risk and outcomes. This study explores the association between Vitamin D deficiency and clinical outcomes in CSDH patients.

Methods: We conducted a retrospective analysis using the TriNetX database to identify CSDH patients with recorded Vitamin D levels between 2012 and 2022. Cases were selected based on specific CSDH-related ICD-10 codes with further refinement using CPT codes (61154, 1009101, 1009104). The incidence of outcomes such as seizures, brain compression, cerebral edema, and coma were then assessed.

Results: After propensity score matching, a total of 24,346 patients were included, with 12,173 patients in each group. The mean age of the Vitamin D deficiency group was 68.0 ±18.7 years (vs. the normal Vitamin D group aged 68.7±17.9 years, p = 0.005) and The vitamin D deficiency group had a higher odds of seizures (OR 1.215, 95% CI [1.135-1.302], (p < 0.001). Brain compression (p < 0.001), craniotomy or burr holes (p < 0.001), and cerebral edema (p < 0.001) occurred less frequently in the Vitamin D deficiency group with no significant difference in the risk of coma being observed between the groups (RD -0.005, 95% CI [-0.010-0.001], p = 0.08).

Conclusion : Vitamin D deficiency presents a complex relationship with CSDH outcomes. While patients displayed an increased risk of seizures, it appears to be associated with a lower risk of brain compression, surgical intervention, and cerebral edema. Further studies are needed to clarify the role of Vitamin D in managing CSDH patients.