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Primary decompressive craniectomy (DC) is carried out to prevent intracranial hypertension after removal of mass lesions resulting from traumatic brain injury (TBI). While primary DC can be a life-saving intervention, significant mortality risks persist during the follow-up period. This study was undertaken to investigate the long-term survival rate and ascertain the risk factors of mortality in TBI patients who underwent primary DC. We enrolled 162 head-injured patients undergoing primary DC in this retrospective study. The primary focus was on long-term mortality, which was monitored over a range of 12 to 209 months post-TBI. We compared the clinical parameters of survivors and non-survivors, and used a multivariate logistic regression model to adjust for independent risk factors of long-term mortality. For the TBI patients who survived the initial hospitalization period following surgery, the average duration of follow-up was 106.58 ± 65.45 months. The recorded long-term survival rate of all patients was 56.2% (91/162). Multivariate logistic regression analysis revealed that age (odds ratio, 95% confidence interval = 1.12, 1.07-1.18; p < 0.01) and the status of basal cisterns (absent versus normal; odds ratio, 95% confidence interval = 9.32, 2.05-42.40; p < 0.01) were the two independent risk factors linked to long-term mortality. In conclusion, this study indicated a survival rate of 56.2% for patients subjected to primary DC for TBI, with at least a one-year follow-up. Key risk factors associated with long-term mortality were advanced age and absent basal cisterns, critical considerations for developing effective TBI management strategies.

Titel:	Long-term survival after primary decompressive craniectomy for severe traumatic brain injury: an observational study from 1 to 17 years.
Autor/in / Beteiligte Person:	Huang, YH ; Lee, TH
Link:	Full Text Finder (Volltext)
Zeitschrift:	Neurosurgical review, Jg. 47 (2024-01-18), Heft 1, S. 51
Veröffentlichung:	Berlin : Springer Berlin Heidelberg ; <i>Original Publication</i>: Berlin : Walter De Gruyter, 2024
Medientyp:	academicJournal
ISSN:	1437-2320 (electronic)
DOI:	10.1007/s10143-024-02289-0
Schlagwort:	Humans Retrospective Studies Treatment Outcome Decompressive Craniectomy adverse effects Brain Injuries, Traumatic surgery Brain Injuries, Traumatic complications Brain Injuries surgery Intracranial Hypertension surgery Intracranial Hypertension etiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Observational Study; Journal Article Language: English [Neurosurg Rev] 2024 Jan 18; Vol. 47 (1), pp. 51. <i>Date of Electronic Publication: </i>2024 Jan 18. MeSH Terms: Decompressive Craniectomy* / adverse effects ; Brain Injuries, Traumatic* / surgery ; Brain Injuries, Traumatic* / complications ; Brain Injuries* / surgery ; Intracranial Hypertension* / surgery ; Intracranial Hypertension* / etiology ; Humans ; Retrospective Studies ; Treatment Outcome References: Maas AIR, Menon DK, Adelson PD et al (2017) Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol 16(12):987–1048. (PMID: 29122524) ; Cooper DJ, Rosenfeld JV, Murray L et al (2011) Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 364(16):1493–1502. 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Long-term survival after primary decompressive craniectomy for severe traumatic brain injury: an observational study from 1 to 17 years.