Background

Chronic subdural haematoma (CSDH) is a common neurosurgical condition resulting from a blood clot within the outer layers of skin around the brain. It is a sentinel health event for individuals, and a significant public health issue.  It is increasingly acknowledged that there are knowledge gaps at all levels of practice following CSDH.  This includes the paucity, poor quality and neglected nature of patient outcomes. 

Aims

This research used a  wellbeing model to integrate components of the knowledge base for CSDH with a focus on patient-related outcomes. The Positive Health model (Huber et al., 2016) was used as a framework for mapping the extant adult CSDH literature that discerns individual health outcomes. 

Method

A rapid review was conducted, with evidence mapped against the positive health model.  The rapid review methodology followed the published guidelines (Pludemann et al., 2018), and was prospectively registered on PROPERO. Evidence-mapping was used to support data synthesis.

Results

Ten studies were identified that used varying assessment measures and follow-up time periods making integration difficult.  Evidence-mapping indicated that the majority of studies (n=9) aligned with the Mental Wellbeing dimension, with limited (n=1) evidence for Bodily Functions, Daily Functioning, Participation and Quality of Life (n=2), and nil evidence for Meaningfulness. 

Conclusion

The need for patient-related outcomes that inform the capacity of an individual to live their lives fully and effectively are integral for evidence-based care in adults after acquired brain injury.  Currently used outcome measures in CSDH do not meet this need.   Stubbs et al. (2022) advocate for neurosurgical research and practice to move beyond its traditional surgical focus, and align with integrated, multidisciplinary, and patient-informed health care. The use of evidence-based positive health frameworks have utility in the integration of previous research, and highlight the utility of multidimensional wellbeing models to support innovation in clinical research and the development of health systems aligned to the needs of patients.