Department of Neurosurgery, The First Affiliated Hospital (YiJiShan Hospital) of Wannan Medical College, Wuhu City, 241001, Anhui, PR China.
Department of Respiratory and Critical Care Medicine, Wuhu Hospital of Traditional Chinese Medicine, Wuhu City, 241001, Anhui, PR China.
BMC Neurol. 2024 Nov 1;24(1):424. doi: 10.1186/s12883-024-03937-0.
Identifying the predictive factors of mortality and functional outcomes following decompressive craniectomy (DC) surgery in patients with malignant middle cerebral artery infarction (MMCAI) is essential for decision-making regarding conservative versus surgical treatment. This study aimed to assess the mortality and functional outcomes of MMCAI patients after DC surgery and to identify the predictive factors associated with mortality and functional outcomes.
A total of 76 patients with MMCAI who underwent surgical DC were included. The mortality rates and functional outcomes were assessed, and factors associated with mortality and functional outcomes were identified through univariate analysis followed by multivariate logistic regression analysis.
The mortality rate was 44.8%, while a favorable functional outcome was observed in 28.9% of the patients. modified Glasgow coma scale (GCS) before DC (OR = 0.416, 95% CI = 0.261-0.662, P < 0.001) and infarct volume before DC (OR = 1.000-1.012, 95% CI = 1.000-1.012, P = 0.037) were independent risk factors for death. Age (OR = 0.88, 95% CI = 0.812-0.952, P = 0.002), modified GCS before DC (OR = 2.477, 95% CI = 1.395-4.4, P = 0.002), and infarct volume before DC (OR = 0.987, 95% CI = 0.975-0.999, P = 0.035) were independent factors associated with favorable functional outcomes.
Preoperative modified GCS and preoperative infarct volume were independent factors associated with both mortality and functional outcomes. Age was only associated with functional outcomes.
识别去骨瓣减压术（DC）治疗恶性大脑中动脉梗死（MMCAI）患者的死亡率和功能预后的预测因素，对于决定保守治疗与手术治疗至关重要。本研究旨在评估 MMCAI 患者 DC 手术后的死亡率和功能预后，并确定与死亡率和功能预后相关的预测因素。
共纳入 76 例接受手术去骨瓣减压的 MMCAI 患者。评估死亡率和功能预后，并通过单因素分析和多因素逻辑回归分析确定与死亡率和功能预后相关的因素。
死亡率为 44.8%，28.9%的患者功能预后良好。去骨瓣减压术前改良格拉斯哥昏迷量表（GCS）评分（OR=0.416，95%CI=0.261-0.662，P<0.001）和去骨瓣减压术前梗死体积（OR=1.000-1.012，95%CI=1.000-1.012，P=0.037）是死亡的独立危险因素。年龄（OR=0.88，95%CI=0.812-0.952，P=0.002）、去骨瓣减压术前改良 GCS 评分（OR=2.477，95%CI=1.395-4.4，P=0.002）和去骨瓣减压术前梗死体积（OR=0.987，95%CI=0.975-0.999，P=0.035）是与功能预后良好相关的独立因素。
术前改良 GCS 和术前梗死体积是死亡率和功能预后的独立影响因素。年龄仅与功能预后相关。
