Original Research Article
Year: 2019 | Month: August | Volume: 6 | Issue: 8 | Pages: 347-363
A Prospective Study of Complications and Outcome after Decompressive Craniectomy in Traumatic Brain Injury in a Tertiary Care Hospital
Dr. Gaurav Dhakre1, Dr Amit Dagar2, Dr. Laxmi Narayan Gupta3
1Consultant Neurosurgery, Nayati Hospital, Agra, Uttar Pradesh.
Ex-Senior Resident, Department of Neurosurgery, Post Graduate Institute of Medical Education and Research &Dr. Ram ManoharLohia Hospital, New Delhi
2Assistant Professor, Department of Neurosurgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi
3Professor, Department of Neurosurgery, Post Graduate Institute of Medical Education and Research &Dr. Ram ManoharLohia Hospital, New Delhi
Corresponding Author: Dr Amit Dagar
ABSTRACT
Background: Decompressive craniectomy is most effective when used in conjunction with duraplasty. Decompressive craniectomy already has been proposed as a last ditch procedure in cases of uncontrollable raised intracranial pressure of various origins.
Methods: This was a prospective observational study of patients with traumatic brain injury who underwent Decompressive craniectomy over a period of 18 months. A total of 96 patients were included in the study. Patients were followed up over a period of 3 months to identify the complications and outcome after decompressive craniectomy. The data was analysed using SSPE software (Chicago, Illinois, USA). P value of 0.05 was considered as statistically significant.
Results: Final outcome was compared with various variables and there was no significant correlation when compared with age, sex, mode of injury, side and type of procedure (p-value>0.05). On comparision of final outcome with preoperative GCS, postoperative GCS, and postoperative neurological status there was significant correlation (p-value<0.05). Incidences of complications were compared with various variables but no significant correlation found.
Conclusion: The survival rate of 83.9% was promising and 48.4% had favourable outcome. We conclude that those patients who had poor pre and postoperative GCS, they had more incidence of unfavourable outcome.
Key words: Decompressive Craniectomy, Traumatic Brain Injury, Glasgow Outcome Scale
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