Incidence and risk factors of early postoperative complications in patients after decompressive craniectomy: a5-year experience.

Abstract

Decompressive craniectomy is an effective measure to reduce apathologically elevated intracranial pressure. Patients' survival and life quality following this surgery have been asubject of several studies and significantly differ according to the primary diagnosis. Since this operation is often associated with awide spectrum of possibly serious complications, we aimed to describe their incidence and possible associated risk factors. We evaluated 118 patients who underwent decompressive craniectomy at our clinic during years 2013-2017. The indications included traumatic brain injuries, ischaemic or haemorrhagic strokes and postoperative complications of planned neurosurgical procedures. Subsequently, we assessed the incidence of early postoperative complications (occurring during the first 3 postoperative weeks). The results were statistically analysed with relation to awide selection of possible risk factors. At least one early surgical postoperative complication occurred in 87 (73.73%) patients, the most frequent being adevelopment of an extraaxial fluid collection in 41 (34.75%) patients. We were able to identify risk factors linked with extraaxial fluid collections, subcutaneous and extradural haematomas, postoperative seizures and meningitis. An overall need for reoperation was 13.56%. Neither the duration of the surgery nor the qualification of the operating surgeon had any effect on the complications' occurrence. Decompressive craniectomy is associated with numerous early postoperative complications with avarious degree of severity. Most cases of complications can, however, be managed in aconservative way. The risk factors linked with postoperative complications should be taken into account during the indication process in each individual patient.