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Critical Age Affecting Functional Outcome after Decompressive Hemicraniectomy for Malignant Hemispheric Infarction
Jaechan Park1, Wonsoo Son1, Joomi Lee2
1Department of Neurosurgery, Kyungpook National University, Daegu, Republic of Korea; Research Center for Neurosurgical Robotic Systems, Kyungpook National University, Daegu, Republic of Korea.
World Neurosurgery
|June 9, 2016
Summary
Advanced age predicts poor outcomes after hemicraniectomy for stroke. Patients over 58 years old have an 82% chance of an unfavorable outcome, while those over 67 years old have a 100% chance.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Hemicraniectomy is a life-saving procedure for malignant hemispheric infarction.
- Age is a known factor influencing functional outcomes post-hemicraniectomy.
- Previous studies used arbitrary age cut-offs, lacking precision.
Purpose of the Study:
- To identify predictors of functional outcome after hemicraniectomy.
- To determine a critical age threshold for unfavorable outcomes.
Main Methods:
- Retrospective analysis of 38 patients undergoing hemicraniectomy for large hemispheric infarction.
- Correlation of clinical variables with 1-year modified Rankin Scale (mRS) scores.
- Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis for age.
Main Results:
- Advanced age is a significant predictor of unfavorable 1-year functional outcome (mRS ≥4).
- An age cut-off of >58 years predicted unfavorable outcomes with 82% positive predictive value (PPV).
- An age cut-off of >67 years predicted unfavorable outcomes (mRS ≥4) with 100% PPV.
Conclusions:
- Advanced age is a significant predictor of poor functional outcomes and dependency after hemicraniectomy.
- Age >58 years has an 82% PPV for unfavorable outcomes, while age >67 years has a 100% PPV.
- This study establishes critical age thresholds for predicting outcomes in stroke patients undergoing hemicraniectomy.
