Decompressive craniectomy for severe traumatic brain injury : functional outcome at 3 months and 6 months

Abstract

Head injury was the commonest diagnosis leading to intensive care unit (ICU) admission in 2008 and it contributed high disease burden which later may lead to socioeconomic problem. Purpose of this study is to determine the functional outcome of decompressive craniectomy (DC) for severe traumatic brain injury patients in HTAA and the associative factors in the poor functional outcome of severe TBI patients who had undergone DC at 3 months and 6 month. From 2017 through 2018, we recruited 54 patients in our local center, 16 to 65 years of age with severe traumatic brain injury that has to undergo decompressive craniectomy. The primary outcome was the rating on the Extended Glasgow Outcome Scale (GOS-E) (an 8-point scale, ranging from death to “upper good recovery” (no injury-related problems) at 3 months and 6 months. We used Pearson chi-square or Fisher Exact test to identify the associations between the study variables and the functional outcome for univariate analysis. This study is ethically approved by National Malaysia Research Committee. The proportional odds assumption was rejected, and therefore results are reported descriptively. Good functional outcome at 3 month among severe TBI patients noted for patients with Marshall score less than 4 and at poor functional outcome noted at 6 months for smoker and GCS than 5 upon presentation. Patient selection and patient resuscitation with Multidiciplinary Team (MDT) involvement may be expected to further improve the outcome following the procedure in severely brain-injured patients.