Predictors of Outcome of Decompressive Craniectomy Following Traumatic Brain Injury | ||||
| Benha Medical Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 04 December 2024 PDF (540.74 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/bmfj.2024.326277.2221 | ||||
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| Authors | ||||
Omar Yousri Basuoni Rezk  1; Ahmed Mohamed Deabes2; Ramy Abdelmenam Teama3; Mahmoud Mohamed Wahdan3; Ashraf El-dosouky El-tantawy4
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| 1Resident of Neurosurgery, Benha University Hospitals, Benha, Egypt | ||||
| 2Assistant Professor of neurosurgery, Faculty of Medicine, Benha University, Benha, Egypt | ||||
| 3Assistant Professor of Neurosurgery, Faculty of Medicine, Benha University, Benha, Egypt | ||||
| 4Professor of Neurosurgery, Faculty of Medicine, Benha University, Benha, Egypt | ||||
| Abstract | ||||
| Background: Traumatic brain injury is a worldwide major and challenging public health problem responsible for 39% global mortality. TBI is considered one of the leading causes of death in pediatrics and adults less than 45 years. This study aimed to primarily evaluate the outcome of decompressive craniectomy in TBI and secondly to assess the factors that may predict the outcome of DC in those patients. Methods: This prospective cohort study was conducted on 30 patients with TBI with increased intracranial pressure not responding to medical treatment. All studied cases underwent neurological examination, radiological and laboratory investigations. Results: Regarding the factors associated with poor outcome, in the univariate analysis, it was found that older age, the lower the Glasgow coma scale (GCS) at admission, the longer duration between injury and operation, the more midline shift, presence of associated clinical features and bilaterality of DC. Those factors were significantly associated with poor outcome (death or severe disability), with p-values of 0.02, 0.03, 0.002, 0.02, 0.03, 0.01 and 0.04, respectively. In the multivariate analysis, only lower GCS, longer duration from injury and operation and bilaterality of DC were significant predictors associated with poor neurological outcome. Conclusion: We observed a high mortality rate of 46.7%. Factors such as old age, lower GCS at admission, longer time from injury to surgery, presence of bilateral unreactive pupils and associated injuries were associated with poor outcomes. While midline shift improved postoperatively, complications such as residual subdural hematoma and wound infections were common. | ||||
| Keywords | ||||
| Decompressive Craniectomy; Traumatic Brain Injury; Glasgow coma scale | ||||
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