AI Article Synopsis
- Swollen middle cerebral artery infarction can be fatal, but decompressive craniectomy surgery has improved survival rates, though many patients still do not make it out of the hospital.
- Researchers at Oslo University Hospital analyzed data from patients who underwent this surgery to identify factors that predict early in-hospital death, focusing on variables like age, stroke onset time, and the extent of brain damage.
- Their findings revealed that having infarction in additional brain territories significantly increases the risk of early death after the surgery, though the small sample size limits the strength of their conclusions.
Article Abstract
Background: Swollen middle cerebral artery infarction is a life-threatening disease and decompressive craniectomy is improving survival significantly. Despite decompressive surgery, however, many patients are not discharged from the hospital alive. We therefore wanted to search for predictors of early in-hospital death after craniectomy in swollen middle cerebral artery infarction.
Methods: All patients operated with decompressive craniectomy due to swollen middle cerebral artery infarction at the Department of Neurosurgery, Oslo University Hospital Rikshospitalet, Oslo, Norway, between May 1998 and October 2010, were included. Binary logistic regression analyses were performed and candidate variables were age, sex, time from stroke onset to decompressive craniectomy, NIHSS on admission, infarction territory, pineal gland displacement, reduction of pineal gland displacement after surgery, and craniectomy size.
Results: Fourteen out of 45 patients (31%) died during the primary hospitalization (range, 3-44 days). In the multivariate logistic regression model, middle cerebral artery infarction with additional anterior and/or posterior cerebral artery territory involvement was found as the only significant predictor of early in-hospital death (OR, 12.7; 95% CI, 0.01-0.77; p = 0.029).
Conclusions: The present study identified additional territory infarction as a significant predictor of early in-hospital death. The relatively small sample size precludes firm conclusions.
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| http://dx.doi.org/10.1007/s00701-016-3049-0 | DOI Listing |
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