Articles Vol. 64 No. 5 23/08/2023

40. ASSESSMENT OF RISK FACTORS AFFECTING THE RESULTS OF DECOMPRESSIVE CRANIECTOMY IN PATIENTS WITH BRAIN INJURY

Vo Thanh Toan1,2, Le Ba Tung1,2, Le Tuong Kha3,4
1 Thong Nhat Hospital
2 Bệnh viện Thống Nhất
3 Cho Ray Hospital
4 Bệnh viện Chợ Rẫy
Corresponding author: lebatungtung@gmail.com
DOI: 10.52163/yhc.v64i5.799
17 Views
11 Downloads
Keywords
Decompressive craniotomy, traumatic brain injury (TBI), intraventricular hemorrhage (ICH), hematoma and cerebral contusion, Rotterdam score.
Abstract

Objectives: To determine the risk factors affecting the results of decompressive craniectomy in patients with traumatic brain injury at Thong Nhat Hospital.

Subjects and Methods: A retrospective cross-sectional study of all patients diagnosed with acute subdural hematoma or hemorrhagic cerebral contusion or both with indications for decompressive craniectomy since January 2017 to January 2020 at Thong Nhat Hospital.

Results: We collected 172 cases that met the stated conditions and obtained the following results: at the time of discharge, most patients had good outcomes (69.18%), 30, 19% of cases had bad outcomes (GOS 1-2-3). The investigated risk factors affecting the poor outcome included: the amount of newly formed hematoma after surgery >22.68ml (p<0.001), compression of the basal cistern (p<0.05), intraventricular hemorrhage (p<0.05), Rotterdam score on CTscan at admission (p<0.05).

Conclusion: Decompressive craniectomy is widely used and saves the lives of many traumatic brain injury patients with intracranial hematoma, but it also brings with it many serious consequences later on. The assessment of clinical and laboratory risk factors helps to choose appropriate treatment and predicts a positive outcome for the patient in the future.

References
[1]
Howard, Jerry Lee et al., “Outcome after Google Scholar
[2]
decompressive craniectomy for the treatment Google Scholar
[3]
of severe traumatic brain injury”, Journal of Google Scholar
[4]
Trauma and Acute Care Surgery, 65(2), 2008, Google Scholar
[5]
pp. 380-386. Google Scholar
[6]
Jennett, Bryan and Bond, Michael, “Assessment Google Scholar
[7]
of outcome after severe brain damage: a practical Google Scholar
[8]
scale”, The Lancet. 305(7905), 1975, pp. 480-484. Google Scholar
[9]
Khan, Farid et al., “Factors affecting functional Google Scholar
[10]
outcome after decompressive craniectomy Google Scholar
[11]
performed for traumatic brain injury: a Google Scholar
[12]
retrospective, cross-sectional study”, Asian Google Scholar
[13]
journal of neurosurgery. 13(03), 2018, pp. Google Scholar
[14]
-736. Google Scholar
[15]
Kurland, David B et al., “Complications Google Scholar
[16]
associated with decompressive craniectomy: a Google Scholar
[17]
systematic review”, Neurocritical care. 23, 2015, Google Scholar
[18]
pp. 292-304. Google Scholar
[19]
Limpastan, Kriengsak et al., “Factors influencing Google Scholar
[20]
the outcome of decompressive craniectomy used Google Scholar
[21]
in the treatment of severe traumatic brain injury”, Google Scholar
[22]
J Med Assoc Thai, 96(6), 2013, pp. 678-82. Google Scholar
[23]
Rutland-Brown, Wesley et al., “Incidence of Google Scholar
[24]
traumatic brain injury in the United States, 2003”, Google Scholar
[25]
The Journal of head trauma rehabilitation. 21(6), Google Scholar
[26]
, pp. 544-548. Google Scholar
[27]
Steyerberg, Ewout W et al., “Predicting outcome Google Scholar
[28]
after traumatic brain injury: development and Google Scholar
[29]
international validation of prognostic scores Google Scholar
[30]
based on admission characteristics”, PLoS Google Scholar
[31]
medicine. 5(8), 2008, p. e165. Google Scholar
[32]
Teasdale, Graham and Jennett, Bryan, Google Scholar
[33]
“Assessment of coma and impaired Google Scholar
[34]
consciousness: a practical scale”, The Lancet. Google Scholar
[35]
(7872), 1974, pp. 81-84. Google Scholar
[36]
Ucar, Tanju et al., “Role of decompressive Google Scholar
[37]
surgery in the management of severe head Google Scholar
[38]
injuries: prognostic factors and patient Google Scholar
[39]
selection”, Journal of neurotrauma; 22(11), Google Scholar
[40]
, pp. 1311-1318. Google Scholar