Jasey Neil, Ward Irene, Lequerica Anthony, Chiaravalloti Nancy D
a Brain Injury Program, Kessler Institute for Rehabilitation , West Orange , NJ , USA.
b Department of Physical Medicine and Rehabilitation New Jersey Medical School Rutgers,The State University of New Jersey , NJ , USA.
Brain Inj. 2018;32(3):318-324. doi: 10.1080/02699052.2017.1419283. Epub 2017 Dec 28.
To examine the effect of cranioplasty on recovery.
Retrospective cohort study.
Retrospective chart review conducted in 2011 and 2012 on adult inpatients with craniectomy who completed a continuous episode of inpatient rehabilitation before and after receiving their cranioplasty. Patients were matched 1:1 or age, gender, functional level at admission, injury severity and length of stay with inpatients who completed rehabilitation before cranioplasty. Main outcome measures include FIM (Functional Independence Measure) and FIM efficiency [(FIM discharge - FIMadmission)/number of days in rehabilitation]. To examine within and between group differences, analyses included paired and independent t-tests, Pearson correlations and chi-square analyses.
Twenty-six individuals (13 from the cranioplasty group and 13 from the comparison group) were analysed. FIM efficiency increased following cranioplasty [0.29 to 0.61; t(12) = -2.77, p = 0.017]. The mean FIM efficiency for the cranioplasty group was below that of the comparison group prior to cranioplasty [0.28 ± 0.37 and 0.39 ± 0.32, p = .41], but increased following cranioplasty [0.61 ± 0.71 and 0.39 ± 0.32, p = .32]. An improvement in FIM efficiency following cranioplasty was more commonly seen among individuals with less severe brain injuries (75%, χ = 3.8, df = 1, p = 0.053).
Rate of recovery increased following cranioplasty and exceeded that of the comparison group suggesting that cranioplasty may contribute to improvement.
研究颅骨修补术对康复的影响。
回顾性队列研究。
2011年和2012年对接受颅骨切除术的成年住院患者进行回顾性病历审查，这些患者在接受颅骨修补术前和术后完成了连续的住院康复治疗。将患者按1:1的比例与在颅骨修补术前完成康复治疗的住院患者进行匹配，匹配因素包括年龄、性别、入院时的功能水平、损伤严重程度和住院时间。主要结局指标包括FIM（功能独立性测量）和FIM效率[（出院时FIM - 入院时FIM）/康复天数]。为检验组内和组间差异，分析包括配对t检验、独立t检验、Pearson相关性分析和卡方分析。
分析了26名个体（颅骨修补术组13名，对照组13名）。颅骨修补术后FIM效率提高[从0.29提高到0.61；t(12) = -2.77，p = 0.017]。颅骨修补术组的平均FIM效率在颅骨修补术前低于对照组[0.28 ± 0.37和0.39 ± 0.32，p = 0.41]，但在颅骨修补术后提高[0.61 ± 0.71和0.39 ± 0.32，p = 0.32]。颅骨修补术后FIM效率的改善在脑损伤较轻的个体中更常见（75%，χ = 3.8，df = 1，p = 0.053）。
颅骨修补术后恢复率提高且超过了对照组，表明颅骨修补术可能有助于改善恢复情况。
