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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Elsevier
2025-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529425001274 |
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| author | Maximilian Bschorer Henrik Giese Julius Höhne Karl Michael Schebesch Christian Henker Andreas Strauss Christina Wolfert Khaled Gaber Aleksandrs Krigers Ondra Petr Vicki M. Butenschoen Sandro M. Krieg Klaus Christian Mende Dirk Lindner Jan Regelsberger Dorothee Mielke Thomas Sauvigny |
| author_facet | Maximilian Bschorer Henrik Giese Julius Höhne Karl Michael Schebesch Christian Henker Andreas Strauss Christina Wolfert Khaled Gaber Aleksandrs Krigers Ondra Petr Vicki M. Butenschoen Sandro M. Krieg Klaus Christian Mende Dirk Lindner Jan Regelsberger Dorothee Mielke Thomas Sauvigny |
| author_sort | Maximilian Bschorer |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-ebffb7b8d8424fe88dc025098171c571 |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Brain and Spine |
| spelling | doaj-art-ebffb7b8d8424fe88dc025098171c5712025-08-20T03:31:28ZengElsevierBrain and Spine2772-52942025-01-01510430810.1016/j.bas.2025.104308German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complicationsMaximilian Bschorer0Henrik Giese1Julius Höhne2Karl Michael Schebesch3Christian Henker4Andreas Strauss5Christina Wolfert6Khaled Gaber7Aleksandrs Krigers8Ondra Petr9Vicki M. Butenschoen10Sandro M. Krieg11Klaus Christian Mende12Dirk Lindner13Jan Regelsberger14Dorothee Mielke15Thomas Sauvigny16Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Corresponding author. Department of Neurosurgery University medical center Hamburg Martinistr. 52 20246 Hamburg, GermanyDepartment of Neurosurgery, Hospital Center Braunschweig, Braunschweig, Germany; Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, GermanyDepartment of Neurosurgery, Paracelsus Medical University Nuernberg, Nuernberg, GermanyDepartment of Neurosurgery, Paracelsus Medical University Nuernberg, Nuernberg, GermanyDepartment of Neurosurgery, University Hospital Rostock, Rostock, Germany; Department of Orthopedic Surgery and Spinal Surgery, KMG Clinics Guestrow, Guestrow, GermanyDepartment of Neurosurgery, University Hospital Rostock, Rostock, GermanyDepartment of Neurosurgery, Georg-August-University, Goettingen, Germany; Department of Neurosurgery, University Hospital Augsburg, Augsburg, GermanyDepartment of Neurosurgery, University Hospital Leipzig, Leipzig, GermanyDepartment of Neurosurgery, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Neurosurgery, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, Munich, GermanyDepartment of Neurosurgery, University Hospital Heidelberg, Heidelberg, GermanyDepartment of Neurosurgery, Friedrich-Ebert-hospital Neumuenster, Neumuenster, GermanyDepartment of Neurosurgery, University Hospital Leipzig, Leipzig, GermanyDepartment of Neurosurgery, Diako Hospital Flensburg, Flensburg, GermanyDepartment of Neurosurgery, University Hospital Augsburg, Augsburg, GermanyDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S2772529425001274CranioplastyDecompressive craniectomyNeurological outcomeStrokeTraumatic brain injuryGlascow outcome score |
| spellingShingle | Maximilian Bschorer Henrik Giese Julius Höhne Karl Michael Schebesch Christian Henker Andreas Strauss Christina Wolfert Khaled Gaber Aleksandrs Krigers Ondra Petr Vicki M. Butenschoen Sandro M. Krieg Klaus Christian Mende Dirk Lindner Jan Regelsberger Dorothee Mielke Thomas Sauvigny German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications Brain and Spine Cranioplasty Decompressive craniectomy Neurological outcome Stroke Traumatic brain injury Glascow outcome score |
| title | German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications |
| title_full | German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications |
| title_fullStr | German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications |
| title_full_unstemmed | German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications |
| title_short | German cranial reconstruction registry – a prospective multicenter cohort study: 883-day follow-up on the outcome and complications |
| title_sort | german cranial reconstruction registry a prospective multicenter cohort study 883 day follow up on the outcome and complications |
| topic | Cranioplasty Decompressive craniectomy Neurological outcome Stroke Traumatic brain injury Glascow outcome score |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425001274 |
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