Craniectomy and craniotomy in traumatic brain injury: A propensity-matched analysis of long-term functional and quality of life outcomes

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J80091

Journal:

World Neurosurgery

Year, Volume, Issue, Page(s):

2018 , 118, , e974-e981

Publication Website:

Abstract:

Study compared the long-term functional and quality of life outcomes after craniectomy (CE), bone removal with later reimplantation, versus craniotomy (CO), bone removal and replacement in the same surgery, in individuals with traumatic brain injury (TBI). Information on 1470 individuals with TBI, who had undergone CE or CO and were matched across all baseline characteristics, were extracted from the TBI Model Systems database from 2002 to 2012. The matched sample was analyzed for outcomes during hospitalization, acute rehabilitation, and at 1- and 2-year of follow-up. Points. Results indicated that CE participants demonstrated a longer median length of stay (LOS) in the hospital (22 versus 18 days) and acute rehabilitation (26 versus 21 days) compared with CO. The CE group had required rehospitalization more often by the 1-year follow-up point (39 versus 25 percent) for reasons other than cranioplasty, including seizures, neurologic events, and infections. Individuals with CE had significantly greater impairment using the Glasgow Outcome Scale-Extended, required more supervision, and were less likely to be employed at 1 and 2 years after TBI. No difference was observed in the satisfaction with life scale scores at 2 years. The Kaplan-Meier mortality estimates at 1 and 2 years showed no differences between the 2 groups. In this study, the individuals who underwent CE compared with CO after TBI had a longer LOS, decreased functional status, and more rehospitalizations. The survival at 2 years and the Satisfaction with Life Scale scores were similar.

Author(s):