TY  - JOUR
PY  - 2017//
TI  - Decompressive craniectomy in the management of intracranial hypertension after traumatic brain injury: a systematic review and meta-analysis
JO  - Scientific reports
A1  - Zhang, Danfeng
A1  - Xue, Qiang
A1  - Chen, Jigang
A1  - Dong, Yan
A1  - Hou, Lijun
A1  - Jiang, Ying
A1  - Wang, Junyu
SP  - e8800
EP  - e8800
VL  - 7
IS  - 1
N2  - We aim to perform a systematic review and meta-analysis to examine the prognostic value of decompressive craniectomy (DC) in patients with traumatic intracranial hypertension. PubMed, EMBASE, Cochrane Controlled Trials Register, Web of Science, http://clinicaltrials.gov/ were searched for eligible studies. Ten studies were included in the systematic review, with four randomized controlled trials involved in the meta-analysis, where compared with medical therapies, DC could significantly reduce mortality rate [risk ratio (RR), 0.59; 95% confidence interval (CI), 0.47-0.74, P < 0.001], lower intracranial pressure (ICP) [mean difference (MD), -2.12 mmHg; 95% CI, -2.81 to -1.43, P < 0.001], decrease the length of ICU stay (MD, -4.63 days; 95% CI, -6.62 to -2.65, P < 0.001) and hospital stay (MD, -14.39 days; 95% CI, -26.00 to -2.78, P = 0.02), but increase complications rate (RR, 1.94; 95% CI, 1.31-2.87, P < 0.001). No significant difference was detected for Glasgow Outcome Scale at six months (RR, 0.85; 95% CI, 0.61-1.18, P = 0.33), while in subgroup analysis, early DC would possibly result in improved prognosis (P = 0.04). <br><br>RESULTS from observational studies supported pooled results except prolonged length of ICU and hospital stay. Conclusively, DC seemed to effectively lower ICP, reduce mortality rate but increase complications rate, while its benefit on functional outcomes was not statistically significant.<p />  <p>Language: en</p>
LA  - en
SN  - 2045-2322
UR  - http://dx.doi.org/10.1038/s41598-017-08959-y
ID  - ref1
ER  -