Decompressive Craniectomy for Hemispheric Infarction in a Low-Income Population
| Autor: | Marco Antonio García-Hernández, César Alessandro Ramos-Delgado, Mariana Romero-González, Angel Martínez-Ponce de León, Jesús Alberto Morales-Gómez, Everardo Garcia-Estrada, Paúl André López-Hernández, Isaac Jair Palacios-Ortiz, Ricardo Gerardo Martínez-Ortíz |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Aging Decompressive Craniectomy medicine.medical_treatment Infarction Single Center Time-to-Treatment Stroke onset medicine Low-Income Population Humans Stroke Poverty Aged Retrospective Studies business.industry Incidence (epidemiology) Incidence Infarction Middle Cerebral Artery Cerebral Infarction Middle Aged medicine.disease Survival Analysis Treatment Outcome Caregiver satisfaction Caregivers Surgery Decompressive craniectomy Female Neurology (clinical) business Follow-Up Studies |
| Zdroj: | World neurosurgery. 156 |
| ISSN: | 1878-8769 |
| Popis: | Stroke is a worldwide leading cause of mortality and disability, and there are substantial economic costs for poststroke care. Disadvantaged populations show increased incidence, severity, and unfavorable outcomes. This study aimed to report the survival, functional outcome, and caregiver satisfaction of low-income patients diagnosed with a large hemispheric infarction (LHI) who underwent decompressive craniectomy (DC).A retrospective analysis was conducted in consecutive adult patients with an LHI who underwent DC at a single center between October 2015 and September 2019. Demographic, clinical, and radiologic data were reviewed. The primary outcomes were 1-year survival and favorable functional outcome.Forty-nine patients were included; those60 years of age showed a higher proportion of favorable functional outcomes (76% vs. 33%; P = 0.031) but similar survival (52% vs. 56%; P = 0.645) than older patients, respectively. Performing the craniectomy in48 hours from stroke onset compared with ≥48 hours showed no statistically significant differences in survival (59% vs. 46%; P = 0.352) and favorable functional outcomes (56% vs. 70%; P = 0.683), respectively. In retrospective thinking, 79% of caregivers would decide to perform the surgery again.Age group and time from stroke onset to craniectomy were not associated with survival; notwithstanding, a higher proportion of patients60 years of age were associated with a favorable functional outcome compared with older patients. Additionally, if given the option, most caregivers would decide to perform the surgery again, independently of the grade of disability of the patient. |
| Databáze: | OpenAIRE |
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