Size of bone flap in decompressive craniectomy: an analysis of complications and prognosis in traumatic brain injury

Objective: To investigate association of size of bone flap with common complications and prognosis in traumatic brain injury. Methods: A retrospective analysis was performed in 108 TBI patients of Northern Jiangsu People's Hospital from January 2018 to March 2019. Patients’ gender, age, Glasgow Coma Scale at admisson, pupils reactivity to the light, size of bone flap, types of craniocerebral injuries and injury locations were recorded. Prognostic indicators including changes in hematoma volume and neurological status were extracted. Statistical methods were conducted to evaluate drug efficacy. Prognostic indicators including Glasgow Outcome Scale scores at discharge and GOS scores of 6 months after operation were extracted to evaluate surgical effcacy.Results : Postoperative complications such as encephalocele and subdural effusion were significantly associated with size of bone flap ( P <0.05). The incidence of encephalocele and SE increased with bone flap size in bone flap groups. Age, GCS at admisson, pupils reactivity to the light, and size of bone flap were shown significantly differences between prognosis groups ( P <0.05). By binary logistic regression, Age, pupils reactivity to the light, and the size of bone flap showed statistical significance ( P <0.05). Conclusion: Size of bone flap in decompressive craniectomy is a dependent factor to prognosis. Avoiding oversize craniectomy may bring less complications and positive prognosis.