A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Early versus delayed cranioplasty after decompressive craniectomy in traumatic brain injury : a multicenter observational study within CENTER-TBI and Net-QuRe
Tekijät: Vreeburg Rick J. G., Singh Ranjit D., van Erp Inge A. M., Korhonen Tommi K., Yue John K., Mee Harry, Timofeev Ivan, Kolias Angelos, Helmy Adel, Depreitere Bart, Moojen Wouter A., Younsi Alexander, Hutchinson Peter, Manley Geoffrey T., Steyerberg Ewout W., de Ruiter Godard C. W., Maas Andrew I. R., Peul Wilco C., van Dijck Jeroen T. J. M., den Boogert Hugo F., Posti Jussi P., van Essen Thomas A.; CENTER-TBI Participants and Investigators
Kustantaja: American Association of Neurological Surgeons
Julkaisuvuosi: 2024
Journal: Journal of Neurosurgery
Tietokannassa oleva lehden nimi: Journal of neurosurgery
Lehden akronyymi: J Neurosurg
Aloitussivu: 1
Lopetussivu: 13
ISSN: 0022-3085
eISSN: 1933-0693
DOI: https://doi.org/10.3171/2024.1.JNS232172
Verkko-osoite: https://thejns.org/view/journals/j-neurosurg/aop/article-10.3171-2024.1.JNS232172/article-10.3171-2024.1.JNS232172.xml
Objective: The aim of this study was to compare the outcomes of early (≤ 90 days) and delayed (> 90 days) cranioplasty following decompressive craniectomy (DC) in patients with traumatic brain injury (TBI).
Methods: The authors analyzed participants enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) and the Neurotraumatology Quality Registry (Net-QuRe) studies who were diagnosed with TBI and underwent DC and subsequent cranioplasty. These prospective, multicenter, observational cohort studies included 5091 patients enrolled from 2014 to 2020. The effect of cranioplasty timing on functional outcome was evaluated with multivariable ordinal regression and with propensity score matching (PSM) in a sensitivity analysis of functional outcome (Glasgow Outcome Scale-Extended [GOSE] score) and quality of life (Quality of Life After Brain Injury [QOLIBRI] instrument) at 12 months following DC.
Results: Among 173 eligible patients, 73 (42%) underwent early cranioplasty and 100 (58%) underwent delayed cranioplasty. In the ordinal logistic regression and PSM, similar 12-month GOSE scores were found between the two groups (adjusted odds ratio [aOR] 0.87, 95% CI 0.61-1.21 and 0.88, 95% CI 0.48-1.65, respectively). In the ordinal logistic regression, early cranioplasty was associated with a higher risk for hydrocephalus than that with delayed cranioplasty (aOR 4.0, 95% CI 1.2-16). Postdischarge seizure rates (early cranioplasty: aOR 1.73, 95% CI 0.7-4.7) and QOLIBRI scores (β -1.9, 95% CI -9.1 to 9.6) were similar between the two groups.
Conclusions: Functional outcome and quality of life were similar between early and delayed cranioplasty in patients who had undergone DC for TBI. Neurosurgeons may consider performing cranioplasty during the index admission (early) to simplify the patient's chain of care and prevent readmission for cranioplasty but should be vigilant for an increased possibility of hydrocephalus. Clinical trial registration nos.: CENTER-TBI, NCT02210221 (clinicaltrials.gov); Net-QuRe, NTR6003 (trialsearch.who.int) and NL5761 (onderzoekmetmensen.nl).
Julkaisussa olevat rahoitustiedot:
CENTER-TBI was supported by the European Union 7th Framework Programme for Research (grant no. 602150; A.I.R.M.), Hannelore Kohl Stiftung (Germany), and OneMind (United States). Net-QuRe was supported by the Hersenstichting Nederland (Dutch Brain Foundation, grant no. ps2014.06). Dr. Korhonen reported research grants from the Finnish Cultural Foundation, Finnish Medical Foundation, and Orion Research Foundation outside the submitted work. Dr. Yue reported grants from the Neurosurgery Research and Education Foundation and Bagan Family Foundation Research Fellowship (award no. A139203, to the University of California, San Francisco) outside the submitted work. Dr. Maas reported grants from the European Union 7th Framework Programme for Research during the conduct of the study. Dr. Peul reported grants from European Committee Grant CENTER-TBI and grants from the Netherlands Brain Foundation during the conduct of the study. Dr. Posti reported funding from the Academy of Finland (grant no. 17379) and the Maire Taponen Foundation. Dr. van Essen reported grants from the European Union 7th Framework Programme for Research or CENTER-TBI and Hersenstichting Nederland (Dutch Brain Foundation) for Net-QuRe and the Niels Stensen Fellowship during the conduct of the study. Dr. Hutchinson is supported by the National Institute for Health and Care Research (Cambridge BRC, Brain Injury Medtech Co-operative, Global Health Research Group on Acquired Brain and Spine Injury, Senior Investigator Award) and the Royal College of Surgeons of England. The funders of the study had no role in study design, data collect
