Analysis of in-hospital death-related factors for acute encephalocele in patients with craniocerebral injury for craniotomy: a report of 183 cases

Abstract

Objective To investigate the in-hospital death-related factors for acute encephalocele in patients with craniocerebral injury for craniotomy in order to provide evidence for clinical treatment and prognosis determination. Methods The clinical data of 183 patients with craniocerebral injury occurring acute encephalocele during craniotomy treated at the Department of Neurosurgery, the 101st Hospital of PLA from August 2008 to July 2014 were analyzed retrospectively. The correlations of the factors including sex, age, preoperative hypoxia, preoperative blood pressure, preoperative Glasgow coma scale (GCS) scores, preoperative pupil status, brain swelling, preoperative intracranial pressure (ICP), causes of encephalocele, postoperative pupillary status, postoperative ICP, postoperative GCS, coagulation mechanism, blood glucose, and complications of the patients of in-hospital deaths were analyzed. Results The prognosis was assessed according to the Glasgow outcome scale (GOS) scores after procedure; there were 135 patients in a death group (namely death cases) and 48 in a survival group (including good recovery, moderate disability, severe disability, and vegetative cases). The postoperative GCS scores, glucose, causes of encephalocele, and postoperative pupillary status were closely associated with the in-hospital death in patients with acute encephalocele in craniocerebral injury operation (P<0.05). There was significant difference in postoperative ICP between the survival group and the death group (P<0.05). Conclusion The postoperative GCS, glucose, causes of encephalocele, postoperative pupillary status, postoperative ICP and postoperative complications could be used as the important indexes for predicting in-hospital death of acute encephalocele in craniocerebral injury for craniotomy. Key words: Craniocerebral trauma; Neurosurgical procedures; Encephalocele; Cause of death