Use of Decompressive Craniectomy in Tbi Patients in a London Major Trauma Centre

C Lopez Soto,G Sivasubramaniam,J Dawson,R Maharaj

doi:10.1186/2197-425x-3-s1-a489

C Lopez Soto, G Sivasubramaniam + Show 2 more

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https://doi.org/10.1186/2197-425x-3-s1-a489

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Abstract

Traumatic Brain Injury(TBI) is a serious health problem resulting in 1x106 Emergency admissions per annum in the UK [[1]].39% of patients with severe TBI, or GCS less than 8, die and 60% survive with unfavourable outcomes [[2]].The aim of TBI management is to minimise secondary brain injury from cerebral oedema to maintain brain oxygen delivery, which may be achieved via medical or surgical management, latest by using decompressive craniectomy (DC) in an attempt to reduce intracranial pressure (ICP).However, no current guidelines on its use have been published and its use remains controversial [[3]].

Highlights

Traumatic Brain Injury(TBI) is a serious health problem resulting in 1x106 Emergency admissions per annum in the UK [1]. 39% of patients with severe TBI, or GCS less than 8, die and 60% survive with unfavourable outcomes [[2]].The aim of TBI management is to minimise secondary brain injury from cerebral oedema to maintain brain oxygen delivery, which may be achieved via medical or surgical management, latest by using decompressive craniectomy (DC) in an attempt to reduce intracranial pressure (ICP).no current guidelines on its use have been published and its use remains controversial [3]
We retrospectively collected the following data in all TBI patients admitted to our institution over a 3yr period from July 2011-July 2014:gender, age, APACHE score, presenting GCS
For those patients who received DC, we recorded the indication to proceed to surgery

Summary

Introduction

Traumatic Brain Injury(TBI) is a serious health problem resulting in 1x106 Emergency admissions per annum in the UK [1]. 39% of patients with severe TBI, or GCS less than 8, die and 60% survive with unfavourable outcomes [[2]].The aim of TBI management is to minimise secondary brain injury from cerebral oedema to maintain brain oxygen delivery, which may be achieved via medical or surgical management, latest by using decompressive craniectomy (DC) in an attempt to reduce intracranial pressure (ICP).However, no current guidelines on its use have been published and its use remains controversial [3].

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