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Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury

OBJECTIVE: This research was designed to investigate the prognostic determinants of patients with traumatic brain injury (TBI) undergoing decompressive craniectomy (DC). METHODS: The present study was a retrospective single center research including a total of 112 patients undergoing DC for TBI in L...

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Autores principales: Jiang, Haitao, Hao, Guangshan, Zhang, Rui, Pang, Qi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Professional Medical Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260895/
https://www.ncbi.nlm.nih.gov/pubmed/32494272
http://dx.doi.org/10.12669/pjms.36.4.2045
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author Jiang, Haitao
Hao, Guangshan
Zhang, Rui
Pang, Qi
author_facet Jiang, Haitao
Hao, Guangshan
Zhang, Rui
Pang, Qi
author_sort Jiang, Haitao
collection PubMed
description OBJECTIVE: This research was designed to investigate the prognostic determinants of patients with traumatic brain injury (TBI) undergoing decompressive craniectomy (DC). METHODS: The present study was a retrospective single center research including a total of 112 patients undergoing DC for TBI in Liaocheng People’s Hospital between January 2017 and December 2018. The results were measured by Extended Glasgow Outcome Sale (GOSE). The prognostic determinants were identified by univariate and binary logistic regression analysis between the deaths and survivors or favorable and unfavorable outcomes. RESULTS: At the six-month follow-up, the mortality was 45.5% including 37 (33.0%) patients died within 30 days. The independent prognostic factors of 30-day mortality were age (p=0.033), D-dimer level at admission (p=0.032) and postoperative hypernatremia (p=0.014). Seventy five patients survived more than 30 days after DC, among which 27 (36.0%) patients had unfavorable prognosis (GOSE 1-4) and 48 (64.0%) patients presented favorable prognosis (GOSE 5-8). After 30 days from DC, the occurrence of post-traumatic hydrocephalus(PTH) (p= 0.008) was associated with unfavorable prognosis. CONCLUSIONS: Although DC is an effective treatment for TBI patients, the mortality and morbidity risk remain high. A combination of age, D-dimer level at admission and postoperative hypernatremia may be a good prognostic factor for 30-day mortality. Developing an accurate therapy strategy to prevent and control PTH may be beneficial to the 6-month prognosis for TBI patients undergoing DC.
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spelling pubmed-72608952020-06-02 Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury Jiang, Haitao Hao, Guangshan Zhang, Rui Pang, Qi Pak J Med Sci Original Article OBJECTIVE: This research was designed to investigate the prognostic determinants of patients with traumatic brain injury (TBI) undergoing decompressive craniectomy (DC). METHODS: The present study was a retrospective single center research including a total of 112 patients undergoing DC for TBI in Liaocheng People’s Hospital between January 2017 and December 2018. The results were measured by Extended Glasgow Outcome Sale (GOSE). The prognostic determinants were identified by univariate and binary logistic regression analysis between the deaths and survivors or favorable and unfavorable outcomes. RESULTS: At the six-month follow-up, the mortality was 45.5% including 37 (33.0%) patients died within 30 days. The independent prognostic factors of 30-day mortality were age (p=0.033), D-dimer level at admission (p=0.032) and postoperative hypernatremia (p=0.014). Seventy five patients survived more than 30 days after DC, among which 27 (36.0%) patients had unfavorable prognosis (GOSE 1-4) and 48 (64.0%) patients presented favorable prognosis (GOSE 5-8). After 30 days from DC, the occurrence of post-traumatic hydrocephalus(PTH) (p= 0.008) was associated with unfavorable prognosis. CONCLUSIONS: Although DC is an effective treatment for TBI patients, the mortality and morbidity risk remain high. A combination of age, D-dimer level at admission and postoperative hypernatremia may be a good prognostic factor for 30-day mortality. Developing an accurate therapy strategy to prevent and control PTH may be beneficial to the 6-month prognosis for TBI patients undergoing DC. Professional Medical Publications 2020 /pmc/articles/PMC7260895/ /pubmed/32494272 http://dx.doi.org/10.12669/pjms.36.4.2045 Text en Copyright: © Pakistan Journal of Medical Sciences http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Jiang, Haitao
Hao, Guangshan
Zhang, Rui
Pang, Qi
Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
title Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
title_full Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
title_fullStr Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
title_full_unstemmed Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
title_short Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
title_sort determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260895/
https://www.ncbi.nlm.nih.gov/pubmed/32494272
http://dx.doi.org/10.12669/pjms.36.4.2045
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