Katrin Rauen1,2,3,4,5,6,7, Lara Reichelt1,2, Philipp Probst5, Barbara Schäpers1, Friedemann Müller1, Klaus Jahn1,6, Nikolaus Plesnila2,7. 1. Schoen Clinic Bad Aibling, Bad Aibling, Germany. 2. Institute for Stroke and Dementia Research (ISD), University of Munich Medical Center, Munich, Germany. 3. Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland. 4. Institute for Regenerative Medicine (IREM), University of Zurich, Schlieren, Switzerland. 5. Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), University of Munich, Munich, Germany. 6. German Center for Vertigo and Balance Disorders, University of Munich Medical Center, Munich, Germany. 7. Munich Cluster for Systems Neurology (Synergy), Munich, Germany.
Abstract
OBJECTIVES: Traumatic brain injury is the number one cause of death in children and young adults and has become increasingly prevalent in the elderly. Decompressive craniectomy prevents intracranial hypertension but does not clearly improve physical outcome 6 months after traumatic brain injury. However, it has not been analyzed if decompressive craniectomy affects traumatic brain injury patients' quality of life in the long term. DESIGN: Therefore, we conducted a cross-sectional study assessing health-related quality of life in traumatic brain injury patients with or without decompressive craniectomy up to 10 years after injury. SETTING: Former critical care patients. PATIENTS: Chronic traumatic brain injury patients having not (n = 37) or having received (n = 98) decompressive craniectomy during the acute treatment. MEASUREMENTS AND MAIN RESULTS: Decompressive craniectomy was necessary in all initial traumatic brain injury severity groups. Eight percent more decompressive craniectomy patients reported good health-related quality of life with a Quality of Life after Brain Injury total score greater than or equal to 60 compared with the no decompressive craniectomy patients up to 10 years after traumatic brain injury (p = 0.004). Initially, mild classified traumatic brain injury patients had a median Quality of Life after Brain Injury total score of 83 (decompressive craniectomy) versus 62 (no decompressive craniectomy) (p = 0.028). Health-related quality of life regarding physical status was better in decompressive craniectomy patients (p = 0.025). Decompressive craniectomy showed a trend toward better health-related quality of life in the 61-85-year-old reflected by median Quality of Life after Brain Injury total scores of 62 (no decompressive craniectomy) versus 79 (decompressive craniectomy) (p = 0.06). CONCLUSIONS: Our results suggest that decompressive craniectomy is associated with good health-related quality of life up to 10 years after traumatic brain injury. Thus, decompressive craniectomy may have an underestimated therapeutic potential after traumatic brain injury.
OBJECTIVES:Traumatic brain injury is the number one cause of death in children and young adults and has become increasingly prevalent in the elderly. Decompressive craniectomy prevents intracranial hypertension but does not clearly improve physical outcome 6 months after traumatic brain injury. However, it has not been analyzed if decompressive craniectomy affects traumatic brain injurypatients' quality of life in the long term. DESIGN: Therefore, we conducted a cross-sectional study assessing health-related quality of life in traumatic brain injurypatients with or without decompressive craniectomy up to 10 years after injury. SETTING: Former critical care patients. PATIENTS: Chronic traumatic brain injurypatients having not (n = 37) or having received (n = 98) decompressive craniectomy during the acute treatment. MEASUREMENTS AND MAIN RESULTS: Decompressive craniectomy was necessary in all initial traumatic brain injury severity groups. Eight percent more decompressive craniectomy patients reported good health-related quality of life with a Quality of Life after Brain Injury total score greater than or equal to 60 compared with the no decompressive craniectomy patients up to 10 years after traumatic brain injury (p = 0.004). Initially, mild classified traumatic brain injurypatients had a median Quality of Life after Brain Injury total score of 83 (decompressive craniectomy) versus 62 (no decompressive craniectomy) (p = 0.028). Health-related quality of life regarding physical status was better in decompressive craniectomy patients (p = 0.025). Decompressive craniectomy showed a trend toward better health-related quality of life in the 61-85-year-old reflected by median Quality of Life after Brain Injury total scores of 62 (no decompressive craniectomy) versus 79 (decompressive craniectomy) (p = 0.06). CONCLUSIONS: Our results suggest that decompressive craniectomy is associated with good health-related quality of life up to 10 years after traumatic brain injury. Thus, decompressive craniectomy may have an underestimated therapeutic potential after traumatic brain injury.
Authors: Angelos G Kolias; Hadie Adams; Ivan S Timofeev; Elizabeth A Corteen; Iftakher Hossain; Marek Czosnyka; Jake Timothy; Ian Anderson; Diederik O Bulters; Antonio Belli; C Andrew Eynon; John Wadley; A David Mendelow; Patrick M Mitchell; Mark H Wilson; Giles Critchley; Juan Sahuquillo; Andreas Unterberg; Jussi P Posti; Franco Servadei; Graham M Teasdale; John D Pickard; David K Menon; Gordon D Murray; Peter J Kirkpatrick; Peter J Hutchinson Journal: JAMA Neurol Date: 2022-07-01 Impact factor: 29.907
Authors: Chonghui Zhang; Xiao Qian; Jie Zheng; Pu Ai; Xinyi Cao; Xiaofei Pan; Tao Chen; Yuhai Wang Journal: Biomed Res Int Date: 2022-02-09 Impact factor: 3.411
Authors: Katrin Rauen; Claudia B Späni; Maria Carmela Tartaglia; Maria Teresa Ferretti; Lara Reichelt; Philipp Probst; Barbara Schäpers; Friedemann Müller; Klaus Jahn; Nikolaus Plesnila Journal: Geroscience Date: 2020-10-17 Impact factor: 7.713