Decompressive Hemicraniectomy for Pediatric Traumatic Brain Injury: Long-Term Outcome Based on Quality of Life
| Autor: | Phillip B. Storm, Sherman C. Stein, Patrick Georgoff, Ryan A. Grant, Arun T. Jacob, Gregory G. Heuer, Shabbar F. Danish |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Time Factors Decompression Traumatic brain injury Treatment outcome Quality of life Humans Medicine Child Decompressive hemicraniectomy business.industry General Medicine Decompression Surgical medicine.disease Surgery Survival Rate Treatment Outcome Pediatric brain Brain Injuries Pediatrics Perinatology and Child Health Emergency medicine Quality of Life Neurology (clinical) business Craniotomy |
| Zdroj: | Pediatric Neurosurgery. 47:81-86 |
| ISSN: | 1423-0305 1016-2291 |
| DOI: | 10.1159/000329624 |
| Popis: | Aims: The impact of decompressive hemicraniectomy (DCH) on the overall outcome of pediatric brain injury patients has not been fully determined. In this paper, the authors performed a systematic review of patient outcome based on quality of life following DCH in a pediatric population. Methods: We describe our experience with decompressive craniectomy in pediatric patients and perform a literature review and pooled outcomes analysis to supplement these findings. A total of 13 children underwent DCH for intractable intracranial pressure in our institution from 2000 to 2008. Follow-up was available in 11 patients with 1 death (9%) and 7 survivors (70%) obtaining a favorable outcome (Glasgow Outcome Scale, GOS, scores = 4–5). Results: A literature review to determine the usefulness of DCH identified 17 articles that, when combined with our series, resulted in 186 pediatric DCH cases. Pooled outcomes found 42 deaths and 112 patients who had favorable outcomes at 6 months. The average 6-month mortality was 21.1%, and the pooled mean quality of life among survivors 0.75 (0.68–0.82), midway between moderate disability and good outcome. Conclusions: Based on our findings, DCH results in a majority of pediatric patients having a good outcome based on the GOS score. |
| Databáze: | OpenAIRE |
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