Page 42 - DECISION-MAKING IN SEVERE TRAUMATIC BRAIN INJURY PATIENT OUTCOME, HOSPITAL COSTS, AND RESEARCH PRACTICE

Chapter 2
Tabel II Decompressive Craniectomy
Study information
Chibbaro (2007)15
Italy, 2003-2005 Retrospective
Huang (2013)16 Taiwan, 2006-2008 Retrospective
Ucar (2005)17 Turkey 2001-2003 Retrospective
Bhat (2013)29 India, 2006-2011 Prospective
Park (2014)30 Korea, 2007-2013 Retrospective
Fotakopoulos (2016)31 Greece, 2009-2013 Retrospective
Saade (2014)32 Brazil, 2004-2012 Retrospective
Csokay (2002)33 Hungary, 1997-1999 Retrospective
Kalayci (2013)34 Turkey, 2001-2009 Retrospective
Purpose
Effects of DC in the treatment of severe head injury
Investigate factors related to 30-day mortality after DC
Evaluate benefits of DC in intractable ICH
Effects of combining DC and multi-dural stabs
Outcomes of Ultra- Early DC after s-TBI
Clinical outcome after DC in s-TBI patients
Prognostic factors of DC in treating s-TBI patients
Outcome of a new surgical technique: vascular tunnelling (VT)
Prognostics and value assessment in DC for ASDH
Population
N=48 GCS3-5: 19
N=201 GCS3-5: 67 ASDH: 86% TSAH: 84% CC: 56% EDH: 12%
N=100 GCS4-5: 60 ASDH: 32%
♂ Age Type of GCS score
63 47 Preoperative
72 46 Pre- decompression
68 30 Initial
Pupils
BFDP: 6 UFDP: 18
Unilateral FP: 12 Bilateral FP: 91
NP
NP
Many GCS=3 patients with bilateral DP
NP
ANI: 48% BFDP: 18%
Normal:
34%
NP
BFDP:12 Unilateral DP: 9 Isocoria: 13
40
N=225 s-TBI
ASDH+BE
GCS3-4: 30 40
N=127
GCS3: 27 GCS4-5: 45 ASDH: 62.2% EDH: 2.4% CC: 32.3%
N=101 s-TBI. GCS3-5: 60 ASDH :37% BE:30% IP:21% CC:8%, EDH:7%
N=56 GCS4-5: 29 ASDH:79% CC:28.6% EDH:18% TSAH:18%
N=28
All GCS<5, BE 1: VT: 28
2: Previous cohort: 20
N=34 GCS3-4: 11 ASDH 100%
76 50 Admission
80 42.8 Time of intubation
83 Most Admission/ 40- Prehospital
50
NP NP NP
76 37 Preoperative
> 80 65%= Following 21- trauma