Dinesh Shukla1
BACKGROUND The aim of the study was to investigate the therapeutics effects, complications and factors associated with prognosis of patients with severe Traumatic Brain Injury (TBI) in whom decompressive craniectomy (DC) was performed. METHODS A retrospective study was conducted between 2015 and 2019 and included patients with severe TBI who underwent decompressive craniectomy. The parameters assessed were clinical state using the Glasgow Coma Score (GCS), CT Scan findings, details of DC, complications, factors associated with mortality and neurological outcome upon discharge from hospital using Glasgow Outcome Scale (GOS). RESULTS A total of 83 patients were included in the study. The mean age of the patients was 32 ± 14 years. There were 68 (81.9%) males and 15 (18.1%) females. Most common cause for injury was road traffic accident (62%). The average Glasgow coma score at admission was 7 ± 3.44 (53%). Complications included contralateral hematoma (4.8%), external cerebral herniation (28.9%), seizures (6.0%), hydrocephalus (8.4%), postoperative infection (30.1%) etc. CONCLUSIONS Decompressive craniectomy is an important procedure to save the life of patients with severe TBI. However some complications associated with the procedure have to be kept in mind before using it in a generalised manner. Low GCS at admission, development of hydrocephalus and old age were factors associated with poor outcome.
