scholarly journals Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury

2018 ◽  
Vol 76 (4) ◽  
pp. 257-264 ◽  
Author(s):  
Guilherme Lellis Badke ◽  
João Luiz Vitorino Araujo ◽  
Flávio Key Miura ◽  
Vinicius Monteiro de Paula Guirado ◽  
Nelson Saade ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Developing Country ◽  
Decompressive Craniectomy ◽  
Direct Costs ◽  
High Morbidity ◽  
Prevention Measures ◽  
Total Cost ◽  
Mortality Index ◽  
Epidemiological Profile

ABSTRACT Background: Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile. Methods: A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost. Results: Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44). Conclusions: Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.

scholarly journals Analysis of direct costs of decompressive craniectomy in patients victims of traumatic brain injury

2018 ◽  
Author(s):  
Guilherme Badke ◽  
João Araujo ◽  
Aline Paiva ◽  
Flávio Miura ◽  
Vinicius de Paula Guirado ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Direct Costs

scholarly journals Basal Cisternostomy in Traumatic Brain Injury: An Idea whose Time has Come?

2020 ◽  
Vol 17 (01) ◽  
pp. 03-05 ◽  
Author(s):  
Nishant Goyal ◽  
Punit Kumar ◽  
Jitender Chaturvedi ◽  
Saquib Azad Siddiqui ◽  
Deepak Agrawal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Morbidity And Mortality ◽  
Great Promise ◽  
High Morbidity

AbstractTraumatic brain injury is associated with high morbidity and mortality. Since the introduction of decompressive craniectomy more than a century ago, no major surgical advancement has been introduced in this field in spite of neurosurgery having seen a sea change in general. Basal cisternostomy, introduced recently, is said to have great promise. In this regard, neurosurgeons need to understand the theory behind the recently introduced basal cisternostomy and whether it holds any merit or not.

Decompressive Craniectomy is Associated with Improved Quality of Life Up to Ten Years After Rehabilitation from Traumatic Brain Injury

2019 ◽  
Author(s):  
Katrin Rauen ◽  
Lara Reichelt ◽  
Philipp Probst ◽  
Barbara Schäpers ◽  
Friedemann Müller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy

Early versus late decompressive craniectomy in traumatic brain injury: A retrospective comparative case study

Trauma ◽  
2020 ◽  
pp. 146040862093576
Author(s):  
Nida Fatima ◽  
Mujeeb-Ur-Rehman ◽  
Samia Shaukat ◽  
Ashfaq Shuaib ◽  
Ali Raza ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Regression Analysis ◽  
Brain Injury ◽  
Functional Outcome ◽  
Decompressive Craniectomy ◽  
Univariate Analysis ◽  
Timing Of Surgery ◽  
Comparative Case Study ◽  
Outcome Parameters ◽  
Good Functional Outcome

Objectives Decompressive craniectomy is a last-tier therapy in the treatment of raised intracranial pressure after traumatic brain injury. We report the association of demographic, radiographic, and injury characteristics with outcome parameters in early (<24 h) and late (≥24 h) decompressive craniectomy following traumatic brain injury. Methods We retrospectively identified 204 patients (158 (early decompressive craniectomy) and 46 (late decompressive craniectomy)), with a median age of 34 years (range 2–78 years) between 2015 and 2018. The primary endpoint was Glasgow Outcome Scale Extended (GOSE) at 60 days, while secondary endpoints included Glasgow Coma Score (GCS) at discharge, mortality at 30 days, and length of hospital stay. Regression analysis was used to assess the independent predictive variables of functional outcome. Results With a clinical follow-up of 60 days, the good functional outcome (GOSE = 5–8) was 73.5% versus 74.1% (p = 0.75) in early and late decompressive craniectomy, respectively. GCS ≥ 9 at discharge was 82.2% versus 91.3% (p = 0.21), mortality at 30 days was 10.8% versus 8.7% (p = 0.39), and length of stay in the hospital was 21 days versus 28 days (p = 0.20), respectively, in early and late decompressive craniectomy groups. Univariate analysis identified that GCS at admission (0.07 (0.32–0.18; < 0.05)) and indication for decompressive craniectomy (3.7 (1.3–11.01; 0.01)) are significantly associated with good functional outcome. Multivariate regression analysis revealed that GCS at admission (<9/≥9) (0.07 (0.03–0.16; <0.05)) and indication for decompressive craniectomy (extradural alone/ other hematoma) (1.75 (1.09–3.25; 0.02)) were significant independent predictors of good functional outcome irrespective of the timing of surgery. Conclusions Our results corroborate that the timing of surgery does not affect the outcome parameters. Furthermore, GCS ≥ 9 and/or extra dural hematoma are associated with relatively good clinical outcome after decompressive craniectomy.

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