Relationship between early cranioplasty and outcomes of traumatic brain injury in adult patients

Abstract

Objective To investigate the effects of early cranioplasty post decompressive craniectomy on the outcomes of traumatic brain injury in adult patients. Methods A retrospective analysis was conducted on the clinical data of 72 adult postoperative patients with traumatic brain injury who were admitted to Department of Neurosurgery, Zhongshan Hospital, Xiamen University from January 2015 to June 2017. According to the timing of cranioplasty, the patients were divided into early group (≤3 months after operation, 30 cases) and conventional group (>3 months after operation, 42 cases). The differences in the Glasgow outcome scale (GOS) score, Karnofsky performance scale(KPS) score and mini-mental state examination(MMSE) score between the two groups were compared at 6 months postoperatively, and the rates of postoperative complications were also compared. Results Compared with the conventional group, the GOS change values [the median(lower interquartile, upper interquartile): 1.0(1.0, 1.0)points vs. 1.0(0, 1.0)points], postoperative KPS (70.3±23.3 points vs. 58.8±17.3 points) and MMSE scores (21.0±7.7 points vs. 17.5±6.2 points) were significantly improved in the early group, and the differences were statistically significant (all P 0.05). Conclusion Compared with cranioplasty at 3 months post operation, early cranioplasty does not seem to increase the incidence of postoperative complications and has more significant improvement in the outcomes of patients. Key words: Craniocerebral trauma; Cranioplasty; Decompressive craniectomy; Early; Prognosis