German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications
Introduction: This international prospective multicenter cohort study investigates the long-term surgical complication rate and neurological outcomes in patients who underwent autologous or allogeneic cranioplasty (CP) after decompressive craniectomy (DC) for traumatic brain injury, stroke, aneurysm...
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| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
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| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425001274 |
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| Summary: | Introduction: This international prospective multicenter cohort study investigates the long-term surgical complication rate and neurological outcomes in patients who underwent autologous or allogeneic cranioplasty (CP) after decompressive craniectomy (DC) for traumatic brain injury, stroke, aneurysmatic subarachnoid hemorrhage, and intracranial hemorrhage. Research question: This study investigated the predictors of long-term outcomes and surgical revision after cranioplasty. Materials and methods: Patients who underwent CP with a minimum follow-up of at least 12 months were included. Favorable long-term outcome (FLTO) was defined as a Glasgow Outcome Score (GOS) of 4 or 5 and a modified Rankin scale (mRS) score of <4. Univariate and multivariate analyses were performed. Results: A total of 200 patients with a median follow-up of 883.1 ± 520.5 days were included. Ninety-nine patients (50.0 %) had a FLTO, and the surgical revision rate was 25.0 % (n = 50). Thirty-eight percent (37.7 %) and 27.5 % of patients showed improvement in the mRS and GOS scores, respectively. Simultaneous implantation of a ventriculoperitoneal shunt (OR 6.114) and a time interval of <90 days between DC and CP (OR 2.189) predicted an increase in reoperation rates. The use of subcutaneous drains with suction predicted a lower rate of reoperation (OR .410). Diabetes mellitus (OR .221) and reoperations during the initial stay (OR .347) were negative predictors of FLTO. Implants imbued with antibiotics predicted a positive FLTO (OR 2.973). Discussion and conclusion: Suction drains were predicted to reduce reoperation rates. Simultaneous implantation of VPS and CP within 3 months of DC predicted an increased likelihood of surgical revision. |
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| ISSN: | 2772-5294 |