Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury

Objective: To evaluate risk factors that influences the outcome of decompressive craniectomy (DC) in severe traumatic brain injury patients. Material and Method: The authors' retrospective review of data collected from 826 severe traumatic brain injury patients admitted to the Chiang Mai Univer...

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Main Authors: Kriengsak Limpastan, Thunya Norasetthada, Wanarak Watcharasaksilp, Tanat Vaniyapong
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/52850
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-528502018-09-04T09:33:30Z Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury Kriengsak Limpastan Thunya Norasetthada Wanarak Watcharasaksilp Tanat Vaniyapong Medicine Objective: To evaluate risk factors that influences the outcome of decompressive craniectomy (DC) in severe traumatic brain injury patients. Material and Method: The authors' retrospective review of data collected from 826 severe traumatic brain injury patients admitted to the Chiang Mai University Hospital between January 1, 2006 and December 31, 2008. During this period, 159 of 826 patients (19.25%) underwent DC and the craniectomy size was not smaller than a fronto-temporo-parietal or a bifrontal bone flap. Data collected included demographics, pre-and post-operative Glasgow coma scores (GCS), timing of surgery, complications, and Glasgow outcome score (GOS) at discharge and six months after surgery. At our institution, patients are managed using the Brain Trauma Foundation guidelines. Results: One hundred fifty nine patients were identified, 130 (81.76%) male and 29 (18.23%) female. One hundred twenty two patients were operated within the first 24 hours after admission. Overall mortality rate was 44.65%. The survival group was younger (30.73 years vs. 43.46 years, p<0.001) and had a higher pre-craniectomy GCS (6 vs. 5, p = 0.002). Of the 88 survivors, favorable outcome was achieved in 21 patients (13.20%) at discharge and increased to 38 patients (23.89%) at six months after surgery. Those with favorable outcome were younger (25.43 years vs. 38.35 years, p = 0.001) and had a higher pre-craniectomy GCS (p = 0.013). Conclusion: Younger age group patients and higher pre-operative GCS are two factors that influence the outcome of DC. Early decompressive craniectomy in patients with higher GCS may result in better functional outcomes. 2018-09-04T09:33:30Z 2018-09-04T09:33:30Z 2013-06-13 Journal 01252208 2-s2.0-84878767620 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84878767620&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/52850
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Kriengsak Limpastan
Thunya Norasetthada
Wanarak Watcharasaksilp
Tanat Vaniyapong
Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
description Objective: To evaluate risk factors that influences the outcome of decompressive craniectomy (DC) in severe traumatic brain injury patients. Material and Method: The authors' retrospective review of data collected from 826 severe traumatic brain injury patients admitted to the Chiang Mai University Hospital between January 1, 2006 and December 31, 2008. During this period, 159 of 826 patients (19.25%) underwent DC and the craniectomy size was not smaller than a fronto-temporo-parietal or a bifrontal bone flap. Data collected included demographics, pre-and post-operative Glasgow coma scores (GCS), timing of surgery, complications, and Glasgow outcome score (GOS) at discharge and six months after surgery. At our institution, patients are managed using the Brain Trauma Foundation guidelines. Results: One hundred fifty nine patients were identified, 130 (81.76%) male and 29 (18.23%) female. One hundred twenty two patients were operated within the first 24 hours after admission. Overall mortality rate was 44.65%. The survival group was younger (30.73 years vs. 43.46 years, p<0.001) and had a higher pre-craniectomy GCS (6 vs. 5, p = 0.002). Of the 88 survivors, favorable outcome was achieved in 21 patients (13.20%) at discharge and increased to 38 patients (23.89%) at six months after surgery. Those with favorable outcome were younger (25.43 years vs. 38.35 years, p = 0.001) and had a higher pre-craniectomy GCS (p = 0.013). Conclusion: Younger age group patients and higher pre-operative GCS are two factors that influence the outcome of DC. Early decompressive craniectomy in patients with higher GCS may result in better functional outcomes.
format Journal
author Kriengsak Limpastan
Thunya Norasetthada
Wanarak Watcharasaksilp
Tanat Vaniyapong
author_facet Kriengsak Limpastan
Thunya Norasetthada
Wanarak Watcharasaksilp
Tanat Vaniyapong
author_sort Kriengsak Limpastan
title Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
title_short Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
title_full Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
title_fullStr Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
title_full_unstemmed Factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
title_sort factors influencing the outcome of decompressive craniectomy used in the treatment of severe traumatic brain injury
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84878767620&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/52850
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