Mortality During In-Hospital Stay and the First 24 h After Decompressive Craniectomy in Severe Traumatic Brain...

Area of Science:

• Neurosurgery
• Trauma Surgery
• Critical Care Medicine

Background:

• Early mortality following trauma is recognized, but poorly understood after traumatic brain injury (TBI) treated with decompressive craniectomy (DC).
• Characterizing in-hospital mortality patterns in TBI patients undergoing DC is crucial for improving patient outcomes.

Purpose of the Study:

• To characterize patients who die during their in-hospital stay after severe TBI and DC.
• To identify factors associated with early mortality in this patient cohort.

Main Methods:

• Subgroup analysis of a retrospective, multicenter, observational study.
• Inclusion of non-survivors from in-hospital stays treated for severe TBI and DC.
• Propensity score matching (PSM) applied to analyze survival differences.

Main Results:

• Out of 223 patients with severe TBI treated with DC, 65 (29.1%) did not survive, with 22 (33.8%) dying within 24 hours.
• Non-survivors were older and more likely to present with pupillomotor dysfunction and higher admission heart rate.
• Multivariate analysis identified age, Quick value, and heart rate as significant predictors of mortality.

Conclusions:

• Chronological age and comorbidities significantly influence mortality even after DC for severe TBI.
• The utility of DC in an aging population with severe TBI warrants further investigation through prospective studies.