scholarly journals #1: Pediatrics Institutional COVID-19 review

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S4-S5
Author(s):  
Uzma Hasan ◽  
Prakash Karna
Keyword(s):  
Medical Center ◽  
Age Distribution ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
The United States ◽  
Health Concern ◽  
Study Patient ◽  
Comorbid Condition ◽  
Global Public Health ◽  
Presenting Symptoms

Abstract Background Coronavirus disease (COVID-19) caused by SARS-COV2 represents global public health concern, with varied severity of illness in different ages and racial groups. This study aims to describe clinical presentation and outcomes in children aged 0–18 years in a community hospital setting in the United States. Methods This is a retrospective medical record review of pediatric patients (0–18 years) admitted to Saint Barnabas Medical Center between March 2020- August 2020 with confirmed diagnosis of COVID-19 infection. Diagnosis of COVID-19 infection is based on ICD-10 diagnosis code from the coding abstract data of the hospital, and data analysis is based on retrospective chart review using electronic medical records for the patients included in the study. Patient data include demographics (age, sex, race), pre-existing conditions, presenting symptoms, treatments used and outcomes. Findings We identified 27 cases of pediatric COVID-19 patients at Saint Barnabas Medical Center during period of March 2020- August 2020. Fever (74%) was the most frequent symptom identified, followed by cough (44%), nausea/vomiting (30%), abdominal pain (19%), headache (19%), diarrhea (15%), shortness of breath (15%), red eyes (15%), rash (11%), chest pain (4%), and loss of taste/smell (4%). 13 out of 27 patients had imaging with chest X-ray, and 7 (54%) had findings of lung infiltrates or opacities. 6 of 27 patients had echocardiogram, and 4 (67%) had positive echocardiogram findings. 11 of 27 patients had some comorbid condition. 17 of 27 (63%) received no treatment. 3 patients (11%) were treated with IVIG + steroids, 2 (7%) received steroids only, 2 (7%) received Remdesivir, 1 (4%) received HCQ, and 1 (4%) received Tocilizumab along with IVIG+ steroids. Only 3 of 27 patients (11%) required supplemental oxygen treatment. No deaths were reported. Of 27 patients, 11 (41%) received inpatient care in general pediatrics, 10 (37%) received care only in ER, 4 (15%) received ICU level of care, and 2 (7%) received care in newborn nursery. Of 27 patients, 17 (63%) were female, and 10 (37%) were male. Race distribution was 48% black, 22% white, 4 % Asian Indian, and 26% others/unknown. Age distribution was 41% aged >15 yrs, 19% aged 6–10 yrs, 15% aged 1–5 yrs, 11% aged 11–15 yrs, 11% newborn, and 4% 0–1 yr. Interpretation This review supports findings from other studies in children showing overall good prognosis in children diagnosed with COVID-19 infection. This study also shows that there is some racial component involved as black children were infected twice as much as white children. However, it requires more longitudinal studies to confirm these findings, and better understand symptomatology and disease course in children with COVID-19 infection.

scholarly journals 485. Pediatrics Institutional COVID-19 Review

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S344-S344
Author(s):  
Prakash Karna ◽  
Lauren Farrand ◽  
Uzma Hasan
Keyword(s):  
Medical Center ◽  
Demographic Data ◽  
Age Distribution ◽  
Hospital Setting ◽  
Severity Of Illness ◽  
Clinical Findings ◽  
Health Concern ◽  
Severe Illness ◽  
Global Public Health ◽  
Presenting Symptoms

Abstract Background Coronavirus disease (COVID-19) caused by SARS-COV2 represents global public health concern, with varied severity of illness in different ages and racial groups. This study aims to describe clinical presentation and outcomes in children aged 0-21 years in a community hospital setting in New Jersey. Methods This is a retrospective medical record review of pediatric patients (0-21 years) admitted to Saint Barnabas Medical Center between March 2020- December 2020 with confirmed diagnosis of COVID-19 infection. Diagnosis of COVID-19 infection is based on ICD-10 diagnosis code. Data was extracted from electronic medical records, including demographics, pre-existing conditions, presenting symptoms, treatments used and outcomes. Results We identified 48 cases of pediatric COVID-19 patients at Saint Barnabas Medical Center during period of 03/20-12/20. Review of demographic data showed 29 patients (60%) were female, and 19 (40%) were male. Race distribution was 38% black, 17% white, 4 % Asian Indian, and 41% others/unknown. Age distribution was as follows: 40% >15 yrs, 15% 11-15 yrs, 15% 0-1 yrs, 13% 6-10 yrs, 13% 1-5 yrs, and 6% newborn. Fever (65%) was the most frequent symptom identified, followed by cough (31%), nausea/vomiting (29%), abdominal pain (19%), shortness of breath (17%), rash (15%), diarrhea (10%), headache (10%), myalgia/body-aches (8%), chest pain (6%), red eyes (6%), and loss of taste/smell (2%). Of 48 patients, 10 (21%) had positive chest X-ray findings of lung infiltrates or opacities, 4 (8%) had abnormal echocardiogram findings, and 1 (2%) had abnormal CT chest. 21 of 48 patients had underlying comorbid conditions, with Diabetes and Asthma being the most common. No deaths were reported. 8 of 48 COVID-19 patients were diagnosed with MIS-C. Of these MIS-C patients, 5 (63%) were male and 3 (38%) were female. 6 of 8 affected patients were black (75%). 50% of MIS-C patients were between 6-10 years. 3 of 8 patients (38%) had abnormal echocardiogram findings. Conclusion This review supports clinical findings from other studies and also suggests certain racial ethnicities may be disproportionately impacted, which warrants further exploration to determine genetics vs environmental factors that lead to increased predisposition to severe illness. Disclosures All Authors: No reported disclosures

scholarly journals 461. Presentation and Demographics of Veterans Tested for COVID-19 Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S297-S298
Author(s):  
Braden Sciarra ◽  
Patrick Kennedy ◽  
Katherine Sherman ◽  
Nicole M Held ◽  
Nathan Gundacker
Keyword(s):  
United States ◽  
African American ◽  
Medical Center ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Duration Of Symptoms ◽  
Presenting Symptoms ◽  
Milwaukee County

Abstract Background COVID-19, caused by the Severe Acute Respiratory Syndrome-Related Coronavirus 2 (SARS-CoV-2), has been a major cause of morbidity and mortality in the United States since its emergence in Wuhan, China. As of June 2020, there are over 20,000 confirmed cases and nearly 700 deaths due to COVID-19 in Wisconsin, with the majority of COVID-19 related deaths occurring within Milwaukee County. COVID-19 infections are disproportionately affecting minority communities across the United States. Presentation and outcomes vary, with the elderly and those with underlying diseases having poorer outcomes. Methods This retrospective chart review of patients tested for COVID-19 infection from March 2020-May 2020 at the Zablocki VA Medical Center, Milwaukee, WI evaluated demographics, comorbidities, presenting symptoms, and duration of symptoms. The primary outcomes analyzed were whether there were significant differences in demographic data, comorbidities, and presentation between patients testing positive or not positive for COVID-19. Results A total of 173 patients tested for COVID-19 were included during the study period, 82 positive and 91 otherwise. Univariate analysis of patient demographics and presenting symptoms are summarized in Table 1. A multivariable logistic regression using stepwise selection (AUC=0.7188) determined patients that tested positive for COVID-19, when controlling for demographics and comorbidities, were more likely to be African-American than White (OR 3.455, CI 1.733–6.887), and more likely to have a diagnosis of diabetes (OR 2.698, CI 1.36–5.353). However, race and diabetes were not informative when symptoms were included in a subsequent model (AUC=0.8458); patients testing positive for COVID-19 were more likely to present with diarrhea (OR 6.926, CI 1.760–6.926) and a higher temperature (OR 2.651, CI 1.533–4.584), but less likely to present with vomiting (OR 0.007, CI < .001-0.161) when compared to patients testing otherwise for COVID-19. Table 1: Univariate Analysis of Variables Associated with Testing Positive for COVID-19 at Zablocki VA Medical Center 3/2020–5/2020 Conclusion Patients testing positive in Milwaukee County are more likely to be African-American and/or diabetic; further highlighting racial disparities in COVID-19. Symptomology at presentation is more related to positive COVID-19 test results than demographics and comorbidities. Disclosures All Authors: No reported disclosures

scholarly journals Evaluation of Thrombotic Risk in Thyroid Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A861-A861
Author(s):  
Chukwuka Akamnonu ◽  
David A Cohen
Keyword(s):  
Pulmonary Embolism ◽  
Thyroid Cancer ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
The United States ◽  
Primary Objective ◽  
Cancer History ◽  
Thrombotic Risk ◽  
History Of

Abstract Introduction: Current guidelines from the International Society of Thrombosis and Hemostasis recommend limited screenings for deep vein thrombosis (DVT) or pulmonary embolism (PE) with no identifiable precipitating factor (termed unprovoked). There is paucity of data with regards to thyroid cancer screening in the setting of an unprovoked VTE. Studies from Europe have shown an association between VTE and thyroid cancer; however, these studies do not account for differences in iodine availability, thus the need for studies in the United States. Understanding the risk of thyroid cancer as a provocative factor in developing a deep venous thrombosis (DVT) or pulmonary embolism (PE) may be able to facilitate case detection of disease and prevent future morbidity and mortality from thyroid cancer and/or VTE. Objectives: The primary objective of this study is to understand the risk of developing VTE in the setting of thyroid cancer. Methods: In this retrospective chart review study, we reviewed electronic medical records of patients with a history of DVT or PE between ages 18-99, presenting to all outpatient clinics at a single academic medical center in New Jersey between October 1, 2015, and Dec 31, 2018. We screened for coexistent cancer history among this group, and from this sample we further isolated cases of thyroid cancer. Results: 345 patients were found to have a history of VTE. 187 were female (54%) and 113 (29%) had a history of malignancy. The most common cancers were breast (19%), colorectal (9%), leukemia (9%), prostate (8%), and lymphoma (8%). Thyroid cancer accounted for 2% of all discovered cases. Conclusion: In this retrospective analysis, 2% of all patients with VTE and cancer carried a diagnosis of thyroid cancer. Although this suggests a relatively low risk, given the medical burden of a venous thromboembolism and the comparable proportion of thyroid cancer in all new cancer cases, thyroid cancer should be considered a provoking factor in unprovoked VTE.

scholarly journals The Use of Probiotics in the Prevention of Clostridium Difficile Infection

2016 ◽  
Author(s):  
Lindsay Mook
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
The United States ◽  
Hospitalized Patients ◽  
Study Results ◽  
Prescribing Trends ◽  
Hospital Acquired

<p>Despite advances in the diagnosis and treatment of Clostridium difficile infection (CDI), the prevention of CDI, particularly in the inpatient hospital setting, remains a challenge. Clostridium difficile now rivals methicillin-resistant staphylococcus aureus (MRSA) as the most common pathogen to cause hospital acquired infections (HAI) in the United States. Hospitalized patients are considered to be especially high risk for CDI, and among inpatient cases, antibiotic treatment, especially with Fluoroquinolones has been an almost universal factor in the development of CDIs. One preventative measure that is incontinently used in the prevention of CDI is oral probiotics. Probiotic consumption is reported to exert a myriad of beneficial effects including enhanced immune response, balancing of colonic microbiota, treatment of diarrhea associated with travel and antibiotic therapy, control of rotavirus and clostridium difficile induced colitis. The American College of Gastroenterology recognizes the role of probiotics and included probiotics as a level B recommendation for the treatment of CDI. It has been hypothesized that the use of probiotics, as an adjunctive therapy in patients receiving antibiotics, may provide a key intervention in reducing primary CDI. The purpose of this study was to conduct a retrospective chart review to explore healthcare providers prescribing trends regarding Fluoroquinolone antibiotics and adjunctive probiotics in patients with hospital acquired CDI. The Synergy model was used to guide the study. Results indicated that probiotics are not frequently prescribed for hospitalized patients on Fluoroquinolones and when they are it is with inconsistency. Additional research is recommended to further assess the use of probiotics in conjunction with other classes of commonly used antibiotics; this study solely looked at Fluoroquinolones.</p>

scholarly journals 464. Structural Vulnerability among Patients with HIV and SARS-CoV-2 Coinfection: Descriptive Case Series from the U.S. Midwest

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S334-S335
Author(s):  
Natasha E Hongsermeier-Graves ◽  
Rohan Khazanchi ◽  
Nada Fadul
Keyword(s):  
Risk Factors ◽  
Disease Progression ◽  
Legal Status ◽  
Medical Center ◽  
Disease Incidence ◽  
Demographic Data ◽  
Case Series ◽  
Retrospective Chart Review ◽  
The United States ◽  
Hiv Disease

Abstract Background It is well known that the HIV epidemic and COVID-19 pandemic have both disproportionately harmed marginalized minority and immigrant communities in the United States. The risk factors associated with disease incidence and outcomes reaffirm that structural vulnerabilities—sociopolitically imposed risk factors like discrimination, legal status, poverty, and beyond which impact a patient’s opportunity to achieve optimal health—play a key role in facilitating the inequitable harms of COVID-19 and HIV alike. This study explores the role of structural forces in increasing the risk of SARS-CoV-2 coinfection among people with HIV (PWH). Methods We performed a retrospective chart review of PWH receiving care at the University of Nebraska Medical Center HIV clinic in Omaha, Nebraska, to collect patient demographics, comorbidities, HIV outcomes, and COVID-19 outcomes for 37 patients with HIV and SARS-CoV-2 coinfection as of August 27, 2020. As a comparison group, we obtained demographic data from a registry of all patients seen at the HIV clinic. We used R Statistical Software to perform descriptive statistical analysis. Results Relative to our overall HIV clinic population, over twice as many Hispanic patients (35.1% vs. 16.0%), three times as many undocumented patients (13.5% vs. 4.2%), and four times as many refugee patients (16.2% vs. 4.0%) had COVID-19. The majority (67.6%) of coinfected patients reported working in “essential” jobs during the pandemic. Thirty-four of the 37 people with HIV and COVID-19 (PWHC) had at least one comorbidity, including increased BMI (83.7%), hypertension (64.9%), or hyperlipidemia (48.6%). All 37 PWHC remained alive as of October 4, 2020. Demographics and HIV Disease Progression of People with HIV and SARS-CoV-2 Coinfection vs. Overall HIV Clinic Registry Demographics and HIV Disease Progression of People with HIV and SARS-CoV-2 Coinfection vs. Overall HIV Clinic Registry (continued) Conclusion The disproportionate burden of SARS-CoV-2 coinfection on Hispanic, undocumented, and refugee PWH may be a product of structural vulnerabilities contributing to greater risk of exposure. Although all 37 PWHC had well-controlled HIV and relatively mild COVID-19 courses, the broader theme of disproportionate COVID-19 incidence among vulnerable sub-populations of people with HIV reaffirms the importance of structural interventions to mitigate current and downstream harms. Disclosures All Authors: No reported disclosures

scholarly journals Utilizing Consumer Health Informatics to Support Management of Hypertension by Clinical Pharmacists in Primary Care: Study Protocol (Preprint)

2017 ◽  
Author(s):  
Lorraine R Buis ◽  
Dana N Roberson ◽  
Reema Kadri ◽  
Nicole G Rockey ◽  
Melissa A Plegue ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Clinical Pharmacist ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Home Blood Pressure ◽  
Health Concern ◽  
Clinical Pharmacists ◽  
Mhealth Intervention

BACKGROUND Hypertension (HTN) is a major public health concern in the United States given its wide prevalence, high cost, and poor rates of control. Multiple strategies to counter this growing epidemic have been studied, and home blood pressure (BP) monitoring, mobile health (mHealth) interventions, and referrals to clinical pharmacists for BP management have all shown potential to be effective intervention strategies. OBJECTIVE The purpose of this study is to establish feasibility and acceptability of BPTrack, a clinical pharmacist-led mHealth intervention that aims to improve BP control by supporting home BP monitoring and medication adherence among patients with uncontrolled HTN. BPTrack is an intervention that makes home-monitored BP data available to clinical pharmacists for use in HTN management. Secondarily, this study seeks to understand barriers to adoption of this intervention, as well as points of improvement among key stakeholders, so that larger scale dissemination of the intervention may be achieved and more rigorous research can be conducted. METHODS This study is recruiting up to 25 individuals who have poorly controlled HTN from a Family Medicine clinic affiliated with a large Midwestern academic medical center. Patient participants complete a baseline visit, including installation and instructions on how to use BPTrack. Patient participants are then asked to follow the BP monitoring protocol for a period of 12 weeks, and subsequently complete a follow-up visit at the conclusion of the study period. RESULTS The recruitment period for the pilot study began in November 2016, and data collection is expected to conclude in late-2017. CONCLUSIONS This pilot study seeks to document the feasibility and acceptability of a clinical pharmacist-led mHealth approach to managing HTN within a primary care setting. Through our 12-week pilot study, we expect to lend support for this approach, and lay the foundation for translating this approach into wider-scale implementation. This mHealth intervention seeks to leverage the multidisciplinary care team already in place within primary care, and to improve health outcomes for patients with uncontrolled HTN. CLINICALTRIAL Clinicaltrials.gov NCT02898584; https://clinicaltrials.gov/ct2/show/NCT02898584 (Archived by WebCite® at http://www.webcitation.org/6u3wTGbe6)

Minimally Invasive Scoliosis Correction in Parkinson Disease: Retrospective Case Series

2020 ◽  
Author(s):  
Ravi S Nunna ◽  
Richard G Fessler
Keyword(s):  
Minimally Invasive ◽  
Parkinson Disease ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The United States ◽  
Invasive Technique ◽  
Radiographic Findings ◽  
Presenting Symptoms ◽  
Scoliosis Correction

Abstract BACKGROUND Parkinson disease (PD) is the second most common neurodegenerative disease in the United States. In the context of the disability inherent to PD, the additional physical challenges and pain from scoliosis can be debilitating for these patients. However, the magnitude of surgery required to correct the deformity combined with the medical co-morbidities and frailty in this population of patients makes surgery very risky. OBJECTIVE To investigate clinical presentations and outcomes of patients with PD that underwent minimally invasive long-segment fusion for scoliosis correction. METHODS A retrospective chart review was performed over the years 2007 to 2017 for patients diagnosed with PD undergoing long-segment spinal fusion (5 or more levels) with the use of circumferential minimally invasive spine surgery techniques. Data including age, sex, race, medical co-morbidities, presenting symptoms, radiographic findings, surgical procedure, case history, and complications were collected from the medical record. RESULTS Retrospective chart review revealed three patients that met the inclusion criteria. They included 2 males and 1 female, with a mean age of 68.7 yr (range 63-75 yr). Ability to maintain upright posture, return to activities of daily living, and visual analog scale (VAS)-back improved in all patients at 1-yr follow-up. Results were durable at 2-yr follow-up. No medical complications were observed. CONCLUSION The generally positive results suggest that minimally invasive technique could have significant benefits in this high-risk group of patients.

Evaluation of Potential Drug–Drug Interactions With Direct Oral Anticoagulants in a Large Urban Hospital

2018 ◽  
Vol 33 (2) ◽  
pp. 136-141 ◽  
Author(s):  
Yoonsun Mo ◽  
Ayse Karakas-Torgut ◽  
Antony Q. Pham
Keyword(s):  
Drug Interactions ◽  
Medical Center ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Potential Drug ◽  
Urban Hospital ◽  
Combined Use

Objective: The aim of this study is to assess patterns of potential drug–drug interactions (DDIs) with direct oral anticoagulants (DOACs) in an inpatient hospital setting. Methods: A retrospective chart review was conducted at the Brookdale University Hospital and Medical Center (BUHMC) from January 2014 to November 2016. All adult patients admitted to the BUHMC who were treated with a DOAC for at least 3 days were screened. Among them, those who received selected interacting drugs at any time during the course of DOAC therapy were included in this study. Results: This study included 165 patients with an average of 73 years (standard deviation [SD] = 12.3) and 233 cases. The most commonly used concomitant drug with a DOAC was aspirin (58%), followed by amiodarone (16%) and P2Y12 inhibitors (11%). The combined use of dual antiplatelet therapy and a DOAC was identified in 18 (6%) cases. Approximately one-third of the cases encountered were classified as the “avoidance” category. Conclusions: Despite computerized DDI alerts, potentially significant DDIs with DOACs still occur. While the present study provides insight into the current patterns of DDIs, further studies are needed to evaluate clinical outcomes of the potential DDIs with DOACs in practice.

Biomedicalization and the Practice of Culture

2018 ◽  
Author(s):  
Mari Armstrong-Hough
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
The United States ◽  
Explanatory Models ◽  
Professional Standards ◽  
Health Concern ◽  
Global Public Health ◽  
Cultural Narratives ◽  
Public Health Concern

Over the last twenty years, type 2 diabetes skyrocketed to the forefront of global public health concern. In this book, Mari Armstrong-Hough examines the rise in and response to the disease in two societies: the United States and Japan. Both societies have faced rising rates of diabetes, but their social and biomedical responses to its ascendance have diverged. To explain the emergence of these distinctive strategies, Armstrong-Hough argues that physicians act not only on increasingly globalized professional standards but also on local knowledge, explanatory models, and cultural toolkits. As a result, strategies for clinical management diverge sharply from one country to another. Armstrong-Hough demonstrates how distinctive practices endure in the midst of intensifying biomedicalization, both on the part of patients and on the part of physicians, and how these differences grow from broader cultural narratives about diabetes in each setting.

A single center's experience with the bedside subdural evacuating port system: a useful alternative to traditional methods for chronic subdural hematoma evacuation

2013 ◽  
Vol 118 (3) ◽  
pp. 694-700 ◽  
Author(s):  
Mina Safain ◽  
Marie Roguski ◽  
Alexander Antoniou ◽  
Clemens M. Schirmer ◽  
Adel M. Malek ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Medical Center ◽  
Chronic Subdural Hematoma ◽  
Retrospective Chart Review ◽  
Attractive Alternative ◽  
Traditional Methods ◽  
Presenting Symptoms ◽  
Significant Difference ◽  
Before And After ◽  
Port System

Object The traditional methods for managing symptomatic chronic subdural hematoma (SDH) include evacuation via a bur hole or craniotomy, both with or without drain placement. Because chronic SDH frequently occurs in elderly patients with multiple comorbidities, the bedside approach afforded by the subdural evacuating port system (SEPS) is an attractive alternative method that is performed under local anesthesia and conscious sedation. The goal of this study was to evaluate the radiographic and clinical outcomes of SEPS as compared with traditional methods. Methods A prospectively maintained database of 23 chronic SDHs treated by bur hole or craniotomy and of 23 chronic SDHs treated by SEPS drainage at Tufts Medical Center was compiled, and a retrospective chart review was performed. Information regarding demographics, comorbidities, presenting symptoms, and outcome was collected. The volume of SDH before and after treatment was semiautomatically measured using imaging software. Results There was no significant difference in initial SDH volume (94.5 cm3 vs 112.6 cm3, respectively; p = 0.25) or final SDH volume (31.9 cm3 vs 28.2 cm3, respectively; p = 0.65) between SEPS drainage and traditional methods. In addition, there was no difference in mortality (4.3% vs 9.1%, respectively; p = 0.61), length of stay (11 days vs 9.1 days, respectively; p = 0.48), or stability of subdural evacuation (94.1% vs 83.3%, respectively; p = 0.60) for the SEPS and traditional groups at an average follow-up of 12 and 15 weeks, respectively. Only 2 of 23 SDHs treated by SEPS required further treatment by bur hole or craniotomy due to inadequate evacuation of subdural blood. Conclusions The SEPS is a safe and effective alternative to traditional methods of evacuation of chronic SDHs and should be considered in patients presenting with a symptomatic chronic SDH.

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