National Chronic Subdural Data Hub (nCSDH)
Research type
Research Study
Full title
Investigating service delivery and potential inequalities in the care of chronic subdural haematoma using a 'national chronic subdural data hub' (nCSDH)
IRAS ID
360380
Contact name
Daniel Stubbs
Contact email
Sponsor organisation
University of Cambridge and Cambridge University Hospitals NHS Foundation Trust
Duration of Study in the UK
3 years, 3 months, 26 days
Research summary
A chronic subdural haematoma (cSDH) is a collection of blood that forms between the skull and brain. It is a common condition in older patients and presents like a ‘slowly evolving stroke’ - with symptoms (such as weakness, confusion, drowsiness and difficulty speaking) coming on over days to weeks.
It can be effectively treated by neurosurgery, but this is only performed in a small number of specialist hospitals. These are grouped with local hospitals into around 20-30 ‘networks’ that provide care for the condition across England and Wales.
Around 80% of people with a cSDH are diagnosed in their local hospital and require transfer to a specialist unit for surgery. This can lead to delays, and creates the potential for harm and variation in outcome. Previous work suggests that those admitted for surgery via another hospital stay a long time in hospital and have high rates of re-admission. Collecting this data is challenging as it is held across different hospitals.
This study aims to examine both the feasibility of running a registry for cSDH (which could help decide if a future national audit might be possible or useful) as well as using the data to address specific research questions relating to care structures, outcomes, and the potential for health inequalities.
We will involve professionals from all parts of the neurosurgical networks (referring and specialist hospitals), so that information can be gathered from the whole patient journey. To do this we need to hold some identifiable information. Because patients with a chronic subdural haematoma are often very unwell when admitted to hospital, and can be drowsy, confused and find it difficult to speak, we have applied for a confidentiality waiver (Section 251 approval from the Confidentiality Advisory Group - CAG), to handle identifiable data without consent. If we don’t do this we risk missing information on the sickest patients which will reduce our ability to use our findings to improve care for all patients with cSDH. We will attempt to seek consent from patients for continued involvement in the study following their operation (to collect information on their recovery and use routine scans to help identify those at greatest risk).
We hope this research will support future work to optimise cSDH care and counsel patients appropriately before surgery.REC name
East of England - Essex Research Ethics Committee
REC reference
26/EE/0053
Date of REC Opinion
19 May 2026
REC opinion
Further Information Favourable Opinion