Risk factors for the development of posttraumatic hydrocephalus after unilateral decompressive craniectomy in patients with traumatic brain injury
| Autor: | Chu-Mei Lan, Nai-Wen Tsai, Tsung-Han Lee, Tsung-Ming Su, Cheng-Hsien Lu, Shih-Wei Hsu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Decompressive Craniectomy Adolescent Traumatic brain injury medicine.medical_treatment 03 medical and health sciences Postoperative Complications 0302 clinical medicine Physiology (medical) Brain Injuries Traumatic medicine Humans Subdural effusion Aged business.industry Incidence Incidence (epidemiology) General Medicine Odds ratio Middle Aged medicine.disease Subdural Effusion Confidence interval Hydrocephalus Neurology Subdural hygroma 030220 oncology & carcinogenesis Anesthesia Female Surgery Decompressive craniectomy Neurology (clinical) business hormones hormone substitutes and hormone antagonists 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neuroscience. 63:62-67 |
| ISSN: | 0967-5868 |
| DOI: | 10.1016/j.jocn.2019.02.006 |
| Popis: | Decompressive craniectomy (DC) has been performed increasingly to control medically refractory intracranial hypertension in patients with traumatic brain injury (TBI). Although DC is a potentially life-saving procedure and technically straightforward, it is associated with some significant complications that include subdural hygroma (SDG) and posttraumatic hydrocephalus (PTH). A retrospective analysis of 143 TBI patients who underwent unilateral DC was undertaken to investigate the incidence and risk factors of PTH and investigate the relationship between the types of SDG and PTH. Among these patients, the incidence of PTH was 30.1%. SDG was noted in 25 patients (58.1%) who developed PTH. SDG was noted in 27 patients (27%) without PTH. The patients with PTH had a significantly unfavorable outcome (p < 0.0001). After stepwise logistic regression analyses, only age (p = 0.004, odds ratio [OR] = 1.036, 95% confidence interval [CI] = 1.011-1.061) and contralateral SDG (p < 0.0001, OR = 5.613, 95% CI = 2.232-14.115) remained independently associated with PTH development, and PTH development rate increased by 3.6% with every 1-year increase in age. Close surveillance is indicated in older TBI patients with contralateral SDG after unilateral DC to prompt early detection and timely management of PTH. |
| Databáze: | OpenAIRE |
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