Decompressive Craniectomy vs. Craniotomy Only for Traumatic Brain Injury: A Propensity-Matched Study of Long-Term Outcomes in Neuropsychology.
Decompressive Craniectomy vs. Craniotomy Only for Traumatic Brain Injury: A Propensity-Matched Study of Long-Term Outcomes in Neuropsychology.
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减压颅骨切除术与仅针对创伤性脑损伤的颅骨切除术：神经心理学长期结果的倾向匹配研究。
DOI：
10.3389/fneur.2022.813140
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发表时间：
2022
影响因子：
3.4
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Guo Z;Ding W;Cao D;Chen Y;Chen J
去骨瓣减压术（DC）和单纯开颅术（CO）通常通过清除颅内出血（ICH）和控制颅内压（ICP）来治疗创伤性脑损伤（TBI）患者。这两种手术的结果已经得到了很好的研究;然而，大多数研究都集中在身体功能上。本研究的目的是评估TBI患者DC或CO后神经心理学的长期结果。从接受DC或CO治疗的TBI患者中收集信息，然后处于术后稳定期（损伤后6-24个月）。倾向评分以1：1的比例匹配患者的人口统计学、损伤原因、TBI亚型、TBI严重程度、计算机断层扫描（CT）结果、手术侧和TBI间隔。我们使用韦克斯勒成人智力量表中文修订版（WAIS-RC）、韦克斯勒记忆量表中文修订版（WMS-RC）、身体自我维持量表（PSMS）、工具性日常生活活动量表（IADL）和格拉斯哥结果量表扩展（GOSE）来衡量TBI患者的长期结局，尤其是神经心理学方面的结局。共有120例TBI患者纳入我们的研究。配对后，74例患者配对为DC组（n = 37）和CO组（n = 37）。在性别上没有差异（P = 1.000），受伤时的年龄（P = 0.268），婚姻状况（P = 0.744），受伤前就业（P = 0.711），合并症（P = 1.000），教育水平（P = 0.969），损伤原因（P = 0.357），TBI亚型（P = 0.305），格拉斯哥昏迷量表（GCS）总分（P = 0.193），意识不清（P = 0.485），创伤性蛛网膜下腔出血（tSAH）（P = 0.102），无反应瞳孔（P = 1.000），中线移位两组间脑池受压或消失（P = 0.485）、手术侧（P = 0.795）和距TBI时间（P = 0.840）的差异。CO组在WAIS-RC OIQ（P = 0.030）和WAIS-RC FIQ（P = 0.021）方面的认知功能更好，在IADL（P = 0.028）和ADL总（P = 0.030）方面的日常功能更好。与CO组相比，DC组的GOSE评分也较低（P = 0.004）。WAIS-VIQ（P = 0.062）、WMS-RC MQ（P = 0.162）和PSMS（P = 0.319）无差异。在匹配队列中，与DC相比，接受CO的患者在认知和日常功能方面具有更好的长期结局。未来的随机对照试验需要对TBI患者的身体和神经心理预后进行深入研究。
Both decompressive craniectomy (DC) and craniotomy only (CO) are commonly performed to treat patients with traumatic brain injury (TBI) by evacuation of intracranial hemorrhage (ICH) and control intracranial pressure (ICP). The outcomes of these two procedures have been well-studied; however, most research studies have focused on physical functions. The purpose of our study is to assess long-term outcomes in neuropsychology after DC or CO in TBI patients. Information was collected from patients with TBI who had undergone DC or CO and were then in the postoperative stable phase (6–24 months after injury). Propensity scoring matched the patients in a 1:1 ratio for demographics, cause of injury, TBI subtype, TBI severity, computed tomography (CT) findings, surgery side, and interval from TBI. We used Wechsler Adult Intelligence Scale-Chinese Revision (WAIS-RC), Wechsler Memory Scale-Chinese Revision (WMS-RC), Physical Self-maintenance Scale (PSMS), Instrumental Activities of Daily Living Scale (IADL), and Glasgow Outcome Scale-Extended (GOSE) to measure the long-term outcomes in TBI patients, especially in neuropsychology. There were 120 TBI patients included in our study. After matching, 74 patients were paired into the DC group (n = 37) and the CO group (n = 37). There were no differences in the gender (P = 1.000), age at injury (P = 0.268), marital status (P = 0.744), pre-injury employment (P = 0.711), comorbidities (P = 1.000), education level (P = 0.969), cause of injury (P = 0.357), TBI subtype (P = 0.305), Glasgow Coma Scale (GCS) total score (P = 0.193), unconsciousness (P = 0.485), traumatic subarachnoid hemorrhage (tSAH) (P = 0.102), unresponsive pupil (P = 1.000), midline shift (P = 0.409), cisterns compressed or absent (P = 0.485), surgery side (P = 0.795), and interval from TBI (P = 0.840) between the two groups. The CO group was associated with better cognitive function in WAIS-RC OIQ (P = 0.030) and WAIS-RC FIQ (P = 0.021) and better daily function in IADL (P = 0.028) and ADL total (P = 0.030). The DC group also had a lower GOSE (P = 0.004) score compared to the CO group. No difference was observed in WAIS-VIQ (P = 0.062), WMS-RC MQ (P = 0.162), and PSMS (P = 0.319). In the matched cohort, patients who underwent CO had better long-term outcomes in cognitive and daily function compared with DC. Future randomized control trials are needed for intensive studies on physical and neuropsychological prognosis in TBI patients.
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DOI：
10.1053/s0003-9993(03)00314-9
发表时间：
2003-11-01
影响因子：
4.3
作者：
Mazzini, L;Campini, R;Oliveri, G
通讯作者：
Oliveri, G
影响因子：
48
作者：
Wilson, Lindsay;Stewart, William;Dams-O'Connor, Kristen;Diaz-Arrastia, Ramon;Horton, Lindsay;Menon, David K.;Polinder, Suzanne
通讯作者：
Polinder, Suzanne
影响因子：
4.2
作者：
Flint, Alexander C.;Manley, Geoffrey T.;Rosenthal, Guy
通讯作者：
Rosenthal, Guy
影响因子：
4.8
作者：
Ashayeri, Kimberly;Jackson, Eric M.;Gordon, Chad R.
通讯作者：
Gordon, Chad R.
影响因子：
3.4
作者：
Jehan, Faisal;Azim, Asad;Joseph, Bellal
通讯作者：
Joseph, Bellal