Article Sidebar

PDF (Tiếng Việt)
Published: 2023-08-23
Abstract Views: 84
Views PDF (Tiếng Việt): 12
DOI: https://doi.org/10.52163/yhc.v64i5.799
Issue
Vol. 64 No. 5
Section
Articles
How to Cite
Toàn, V. T. ., Tùng, L. B. ., & Kha, L. T. . (2023). 40. ASSESSMENT OF RISK FACTORS AFFECTING THE RESULTS OF DECOMPRESSIVE CRANIECTOMY IN PATIENTS WITH BRAIN INJURY. Vietnam Journal of Community Medicine, 64(5). https://doi.org/10.52163/yhc.v64i5.799

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

Vo Thanh Toan1, Le Ba Tung1, Le Tuong Kha2
1 Thong Nhat Hospital
2 Cho Ray Hospital

Main Article Content

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.

Article Details

Keywords

Decompressive craniotomy, traumatic brain injury (TBI), intraventricular hemorrhage (ICH), hematoma and cerebral contusion, Rotterdam score.

References

[1] Howard, Jerry Lee et al., “Outcome after
decompressive craniectomy for the treatment
of severe traumatic brain injury”, Journal of
Trauma and Acute Care Surgery, 65(2), 2008,
pp. 380-386.
[2] Jennett, Bryan and Bond, Michael, “Assessment
of outcome after severe brain damage: a practical
scale”, The Lancet. 305(7905), 1975, pp. 480-484.
[3] Khan, Farid et al., “Factors affecting functional
outcome after decompressive craniectomy
performed for traumatic brain injury: a
retrospective, cross-sectional study”, Asian
journal of neurosurgery. 13(03), 2018, pp.
730-736.
[4] Kurland, David B et al., “Complications
associated with decompressive craniectomy: a
systematic review”, Neurocritical care. 23, 2015,
pp. 292-304.
[5] Limpastan, Kriengsak et al., “Factors influencing
the outcome of decompressive craniectomy used
in the treatment of severe traumatic brain injury”,
J Med Assoc Thai, 96(6), 2013, pp. 678-82.
[6] Rutland-Brown, Wesley et al., “Incidence of
traumatic brain injury in the United States, 2003”,
The Journal of head trauma rehabilitation. 21(6),
2006, pp. 544-548.
[7] Steyerberg, Ewout W et al., “Predicting outcome
after traumatic brain injury: development and
international validation of prognostic scores
based on admission characteristics”, PLoS
medicine. 5(8), 2008, p. e165.
[8] Teasdale, Graham and Jennett, Bryan,
“Assessment of coma and impaired
consciousness: a practical scale”, The Lancet.
304(7872), 1974, pp. 81-84.
[9] Ucar, Tanju et al., “Role of decompressive
surgery in the management of severe head
injuries: prognostic factors and patient
selection”, Journal of neurotrauma; 22(11),
2005, pp. 1311-1318.