OBJECTIVE: To assess detailed long-term clinical outcome at least 1 year after decompressive craniectomy (DC) in patients with severe traumatic brain injury (TBI). METHODS: One hundred and thirty-one patients with severe TBI underwent DC between September 1997 and September 2005. Outcome was measured using the Glasgow Outcome Scale (GOS). Detailed outcome analysis was performed using Glasgow Outcome Scale Extended, Short-Form 36 (SF-36), Beck Depression Inventory, Trail Making Test B (TMT-B), Digit-Symbol Test (DST) and Barthel Index (BI). RESULTS: Sixty-three patients (48.1%) died during their initial hospital stay, 27 (20.6%) were discharged in a vegetative state, 32 (24.4%) with severe disability and nine (6.9%) with moderate disability (GOS 3 and 4, respectively). At time of follow-up 75 patients (67.7%) were either dead or in a vegetative state. Thirty patients with GOS >2 were recruited for a detailed outcome analysis: Major depression, neurologic deficits and impaired TMT-B and DST performances were common and significantly more prevalent than in normative controls. Yet, patients reported only modestly reduced SF-36 and high BI scores. CONCLUSIONS: Despite multiple health-related problems after DC, many patients proved highly functional in activities of daily living and reported qualities of life not significantly inferior to that of healthy individuals. Depression was common and requires to be addressed with patients and caregivers. Better targeted therapies could improve neuropsychological and psychiatric outcomes in this complex cohort.
OBJECTIVE: To assess detailed long-term clinical outcome at least 1 year after decompressive craniectomy (DC) in patients with severe traumatic brain injury (TBI). METHODS: One hundred and thirty-one patients with severe TBI underwent DC between September 1997 and September 2005. Outcome was measured using the Glasgow Outcome Scale (GOS). Detailed outcome analysis was performed using Glasgow Outcome Scale Extended, Short-Form 36 (SF-36), Beck Depression Inventory, Trail Making Test B (TMT-B), Digit-Symbol Test (DST) and Barthel Index (BI). RESULTS: Sixty-three patients (48.1%) died during their initial hospital stay, 27 (20.6%) were discharged in a vegetative state, 32 (24.4%) with severe disability and nine (6.9%) with moderate disability (GOS 3 and 4, respectively). At time of follow-up 75 patients (67.7%) were either dead or in a vegetative state. Thirty patients with GOS >2 were recruited for a detailed outcome analysis: Major depression, neurologic deficits and impaired TMT-B and DST performances were common and significantly more prevalent than in normative controls. Yet, patients reported only modestly reduced SF-36 and high BI scores. CONCLUSIONS: Despite multiple health-related problems after DC, many patients proved highly functional in activities of daily living and reported qualities of life not significantly inferior to that of healthy individuals. Depression was common and requires to be addressed with patients and caregivers. Better targeted therapies could improve neuropsychological and psychiatric outcomes in this complex cohort.
Authors: Cassidy Q B Mostert; Ranjit D Singh; Maxime Gerritsen; Erwin J O Kompanje; Gerard M Ribbers; Wilco C Peul; Jeroen T J M van Dijck Journal: Acta Neurochir (Wien) Date: 2022-01-31 Impact factor: 2.816
Authors: Nicole von Steinbüchel; Ruben G L Real; Nadine Sasse; Lindsay Wilson; Christiane Otto; Ryan Mullins; Robert Behr; Wolfgang Deinsberger; Ramon Martinez-Olivera; Wolfgang Puschendorf; Werner Petereit; Veit Rohde; Holger Schmidt; Stephan Sehmisch; Klaus Michael Stürmer; Klaus von Wild; Henning Gibbons Journal: PLoS One Date: 2017-05-24 Impact factor: 3.240
Authors: Hagen Andruszkow; Ezin Deniz; Julia Urner; Christian Probst; Orna Grün; Ralf Lohse; Michael Frink; Christian Krettek; Christian Zeckey; Frank Hildebrand Journal: Health Qual Life Outcomes Date: 2014-02-26 Impact factor: 3.186