Clinic of Neurosurgery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital in Martin, Kollárova 2, Martin, 036 59, Slovak Republic.
Clinic of Radiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital in Martin, Kollárova 2, Martin, 036 59, Slovak Republic.
Eur J Trauma Emerg Surg. 2021 Oct;47(5):1635-1647. doi: 10.1007/s00068-020-01367-4. Epub 2020 Apr 19.
Decompressive craniectomy is an effective measure to reduce a pathologically elevated intracranial pressure. Patients' survival and life quality following this surgery have been a subject of several studies and significantly differ according to the primary diagnosis. Since this operation is often associated with a wide spectrum of possibly serious complications, we aimed to describe their incidence and possible associated risk factors.
We evaluated 118 patients who underwent decompressive craniectomy at our clinic during years 2013-2017. The indications included traumatic brain injuries, ischaemic or haemorrhagic strokes and postoperative complications of planned neurosurgical procedures. Subsequently, we assessed the incidence of early postoperative complications (occurring during the first 3 postoperative weeks). The results were statistically analysed with relation to a wide selection of possible risk factors.
At least one early surgical postoperative complication occurred in 87 (73.73%) patients, the most frequent being a development of an extraaxial fluid collection in 41 (34.75%) patients. We were able to identify risk factors linked with extraaxial fluid collections, subcutaneous and extradural haematomas, postoperative seizures and meningitis. An overall need for reoperation was 13.56%. Neither the duration of the surgery nor the qualification of the operating surgeon had any effect on the complications' occurrence.
Decompressive craniectomy is associated with numerous early postoperative complications with a various degree of severity. Most cases of complications can, however, be managed in a conservative way. The risk factors linked with postoperative complications should be taken into account during the indication process in each individual patient.
去骨瓣减压术是降低病理性颅内压升高的有效措施。接受这种手术后患者的生存和生活质量是多项研究的主题，且根据主要诊断而显著不同。由于这种手术通常与一系列可能严重的并发症相关，我们旨在描述其发生率和可能相关的危险因素。
我们评估了 2013 年至 2017 年期间在我们诊所接受去骨瓣减压术的 118 名患者。手术指征包括创伤性脑损伤、缺血性或出血性中风以及计划神经外科手术的术后并发症。随后，我们评估了早期术后并发症（发生在术后 3 周内）的发生率。结果与广泛的可能危险因素进行了统计学分析。
至少有 87 名（73.73%）患者发生了早期手术术后并发症，最常见的是 41 名（34.75%）患者发生了轴外液体积聚。我们确定了与轴外液体积聚、皮下和硬膜外血肿、术后癫痫发作和脑膜炎相关的危险因素。总体需要再次手术的比例为 13.56%。手术时间和手术医生的资质均与并发症的发生无关。
去骨瓣减压术与多种不同严重程度的早期术后并发症相关。然而，大多数并发症病例可以通过保守治疗来处理。在为每个患者制定手术指征时，应考虑与术后并发症相关的危险因素。
