Investigation of the predictive factors for mortality in patients undergoing decompressive craniectomy: A retrospective cross-sectional study

dc.authorid0000-0001-9861-274X
dc.authorid0000-0002-9325-1292
dc.contributor.authorÖzeren, Ersin
dc.contributor.authorGüneş, Muzaffer
dc.date.accessioned2022-07-29T06:49:43Z
dc.date.available2022-07-29T06:49:43Z
dc.date.issued2022
dc.departmentTıp Fakültesi
dc.description.abstractMalignant middle cerebral artery (MCA) infarctions and severe traumatic brain injuries (TBI) can cause increased intracranial pressure (ICP), herniation, and eventually lead to death. Decompressive craniectomy (DC) can be life-saving in these patients. The present study aims to investigate the predictive factors for mortality in patients undergoing DC due to malignant MCA infarction and severe TBI. Material and Methods: Between January 2015 and January 2020, clinical and imaging findings, demographic characteristics and laboratory results of patients who underwent DC due to severe TBI and malignant MCA infarction were retrospectively analyzed and recorded for statistical analysis. In order to identify the most significant parameter in relation to mortality, a receiver operating characteristic (ROC) analysis was performed, and the area under the ROC curve was calculated. Results: The study included 30 patients undergoing DC. Out of 12 patients with TBI and 18 with malignant MCA infarction, 6 (50%) and 15 (83.3%), respectively, died. There was no statistically significant difference between survivors and non-survivors in terms of age and gender (p = 0.625 and p = 0.626). Patients who did not survive had significantly lower Glasgow coma scale (GCS) scores than survivors (p = 0.001). Moreover, the degree of midline shift, C-reactive protein-to-albumin ratio (CAR) and red blood cell distribution width (RDW-SD) levels were significantly higher in non-survivors than in survivors (p = 0.017, p = 0.002, and p = 0.009, respectively). The AUC values were as follows: GCS = 0.876 (95% Confidence Interval (CI), 0.733-1), CAR = 0.844 (95% CI, 0.706-0.982), RDW-SD = 0.796 (95% CI, 0.637-0.955), and amount of shift 0.775 (95% CI, 0.602-0.948). Conclusion: The present study found that patients with low GCS, an increased degree of midline shift, and high CAR and RDW-SD values benefit less from DC. It was considered that high CAR and RDW-SD could be a predictive marker for mortality.
dc.identifier.doi10.5455/annalsmedres.2021.03.284
dc.identifier.endpage61en_US
dc.identifier.issn2636-7688
dc.identifier.issn2636-7688
dc.identifier.issue1en_US
dc.identifier.startpage58en_US
dc.identifier.urihttps://dx.doi.org/10.5455/annalsmedres.2021.03.284
dc.identifier.urihttps://hdl.handle.net/20.500.12451/9622
dc.identifier.volume29en_US
dc.indekslendigikaynakTR-Dizin
dc.language.isoen
dc.publisherİnönü Üniversitesi
dc.relation.ispartofAnnals of Medical Research (Ann Med Res)
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subjectC-reactive Protein-to-albumin Ratio
dc.subjectDecompressive Craniectomy
dc.subjectGlasgow Coma Scale
dc.subjectIntracranial Pressure
dc.subjectMalignant Middle Cerebral Artery Infarction
dc.subjectTraumatic Brain Injury
dc.titleInvestigation of the predictive factors for mortality in patients undergoing decompressive craniectomy: A retrospective cross-sectional study
dc.typeArticle

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