Outcomes of Cranioplasty from a Tertiary Hospital in a Developing Country
Introduction: Although cranioplasty (CP) is a straightforward procedure, it may result in a significant number of complications. These include infections, seizures, intracranial hematomas, and others. Many reports have stated that early CP is associated with higher complications; however, more recen...
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| Veröffentlicht in: | Neurology India 2020-01, Vol.68 (1), p.63-70 |
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| description | Introduction: Although cranioplasty (CP) is a straightforward procedure, it may result in a significant number of complications. These include infections, seizures, intracranial hematomas, and others. Many reports have stated that early CP is associated with higher complications; however, more recent articles have contradicted this opinion. We intend to share our experience and results on outcomes of CP from our university hospital.
Materials and Methods: This is a 3-year retrospective analysis of patients undergoing CP. Demographic profile, etiology of decompressive craniectomy (DC), DC-CP interval, operative details, complications, and follow-up data were analyzed. Correlation of complications with timing of CP and other factors was studied to look for statistical significance.
Results: A
total of 93 cases were analyzed. The majority were traumatic and ischemic stroke etiologies. There were eight open/compound head injuries (HIs). Eleven were bilateral and the rest unilateral cases. The mean and median CP interval were 8.5 weeks (range 4-28 weeks) and 8 weeks, respectively. All patients received 48 h to up to 5 days of postoperative antibiotics. Ten complications (10.7%) were noted (including one death). Poor Glasgow Outcome Scale at CP was the only statistically significant factor associated with higher complication rates. There was no statistical difference with respect to gender, CP material, and etiology; however, early CP had slightly fewer complications.
Conclusion: Patients with poor neurological condition at the time of CP have a significantly higher risk of complications. Contrary to earlier reports, early CP ( |
| doi_str_mv | 10.4103/0028-3886.279676 |
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| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_journals_2371209186</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A616261432</galeid><sourcerecordid>A616261432</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490s-a97763566256e2857504cfae89e2d5be697c5a93b0b6140aeb982b21f3b413d33</originalsourceid><addsrcrecordid>eNptkc1PwyAYh4nR6Py4ezJNPHfCS0vLcZmfiYkXPRPavV3QFiq0LvvvZZmfycKBAM_vR-Ah5JzRacYov6IUypSXpZhCIUUh9siESVmmGQXYJ5Of4yNyHMJrXHLO4JAccWAgIRMT8vA0DrXrMCSuSeZeW-P6VodhnTTedYlOntEPRvt1cu9CbwbdJsbG7Wv8wNb1xi6TuRvt4Nen5KDRbcCzr_mEvNzePM_v08enu4f57DGtM0lDqmVRCJ4LAblAKPMip1ndaCwlwiKvUMiizrXkFa0Ey6jGSpZQAWt4lTG-4PyEXG57e-_eRwyDenWjt_FKBbxgQCUrxS-11C0qYxs3eF13JtRqJpiA2M0hUukOaokWvW6dxcbE7X_8dAcfxwI7U-8M0G2g9i4Ej43qvenidypG1Uah2jhSG0dqqzBGLr7eN1YdLn4C384iMNsCK9cO6MNbO67Qq8i-Wbf6V5z-KVaCq2_Z_BPXcafm</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2371209186</pqid></control><display><type>article</type><title>Outcomes of Cranioplasty from a Tertiary Hospital in a Developing Country</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Prasad, G ; Menon, Girish ; Kongwad, Lakshman ; Kumar, Vinod</creator><creatorcontrib>Prasad, G ; Menon, Girish ; Kongwad, Lakshman ; Kumar, Vinod</creatorcontrib><description>Introduction: Although cranioplasty (CP) is a straightforward procedure, it may result in a significant number of complications. These include infections, seizures, intracranial hematomas, and others. Many reports have stated that early CP is associated with higher complications; however, more recent articles have contradicted this opinion. We intend to share our experience and results on outcomes of CP from our university hospital.
Materials and Methods: This is a 3-year retrospective analysis of patients undergoing CP. Demographic profile, etiology of decompressive craniectomy (DC), DC-CP interval, operative details, complications, and follow-up data were analyzed. Correlation of complications with timing of CP and other factors was studied to look for statistical significance.
Results: A
total of 93 cases were analyzed. The majority were traumatic and ischemic stroke etiologies. There were eight open/compound head injuries (HIs). Eleven were bilateral and the rest unilateral cases. The mean and median CP interval were 8.5 weeks (range 4-28 weeks) and 8 weeks, respectively. All patients received 48 h to up to 5 days of postoperative antibiotics. Ten complications (10.7%) were noted (including one death). Poor Glasgow Outcome Scale at CP was the only statistically significant factor associated with higher complication rates. There was no statistical difference with respect to gender, CP material, and etiology; however, early CP had slightly fewer complications.
Conclusion: Patients with poor neurological condition at the time of CP have a significantly higher risk of complications. Contrary to earlier reports, early CP (<12 weeks) was not associated with higher complications but rather fewer complications than delayed procedures. Adherence to a few simple steps may help reduce these complications.</description><identifier>ISSN: 0028-3886</identifier><identifier>EISSN: 1998-4022</identifier><identifier>DOI: 10.4103/0028-3886.279676</identifier><identifier>PMID: 32129246</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Abdomen ; Adolescent ; Adult ; Aged ; Analysis ; Antibiotics ; Child ; Child, Preschool ; Convulsions & seizures ; Decompressive Craniectomy - methods ; Developing Countries ; Etiology ; Etiology (Medicine) ; Female ; Fractures ; Health aspects ; Humans ; Infant ; Infection ; Infections ; Male ; Middle Aged ; Ostomy ; Patients ; Polymethyl methacrylate ; Postoperative Complications - etiology ; Postoperative Complications - surgery ; Reconstructive Surgical Procedures - methods ; Retrospective Studies ; Seizures (Medicine) ; Seizures - etiology ; Skull - surgery ; Statistical analysis ; Stroke - etiology ; Stroke - surgery ; Surgery ; Tertiary Care Centers ; Titanium ; Trauma ; Traumatic brain injury ; Young Adult</subject><ispartof>Neurology India, 2020-01, Vol.68 (1), p.63-70</ispartof><rights>COPYRIGHT 2020 Medknow Publications and Media Pvt. Ltd.</rights><rights>2020. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490s-a97763566256e2857504cfae89e2d5be697c5a93b0b6140aeb982b21f3b413d33</citedby><cites>FETCH-LOGICAL-c490s-a97763566256e2857504cfae89e2d5be697c5a93b0b6140aeb982b21f3b413d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32129246$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prasad, G</creatorcontrib><creatorcontrib>Menon, Girish</creatorcontrib><creatorcontrib>Kongwad, Lakshman</creatorcontrib><creatorcontrib>Kumar, Vinod</creatorcontrib><title>Outcomes of Cranioplasty from a Tertiary Hospital in a Developing Country</title><title>Neurology India</title><addtitle>Neurol India</addtitle><description>Introduction: Although cranioplasty (CP) is a straightforward procedure, it may result in a significant number of complications. These include infections, seizures, intracranial hematomas, and others. Many reports have stated that early CP is associated with higher complications; however, more recent articles have contradicted this opinion. We intend to share our experience and results on outcomes of CP from our university hospital.
Materials and Methods: This is a 3-year retrospective analysis of patients undergoing CP. Demographic profile, etiology of decompressive craniectomy (DC), DC-CP interval, operative details, complications, and follow-up data were analyzed. Correlation of complications with timing of CP and other factors was studied to look for statistical significance.
Results: A
total of 93 cases were analyzed. The majority were traumatic and ischemic stroke etiologies. There were eight open/compound head injuries (HIs). Eleven were bilateral and the rest unilateral cases. The mean and median CP interval were 8.5 weeks (range 4-28 weeks) and 8 weeks, respectively. All patients received 48 h to up to 5 days of postoperative antibiotics. Ten complications (10.7%) were noted (including one death). Poor Glasgow Outcome Scale at CP was the only statistically significant factor associated with higher complication rates. There was no statistical difference with respect to gender, CP material, and etiology; however, early CP had slightly fewer complications.
Conclusion: Patients with poor neurological condition at the time of CP have a significantly higher risk of complications. Contrary to earlier reports, early CP (<12 weeks) was not associated with higher complications but rather fewer complications than delayed procedures. Adherence to a few simple steps may help reduce these complications.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Antibiotics</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Convulsions & seizures</subject><subject>Decompressive Craniectomy - methods</subject><subject>Developing Countries</subject><subject>Etiology</subject><subject>Etiology (Medicine)</subject><subject>Female</subject><subject>Fractures</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infant</subject><subject>Infection</subject><subject>Infections</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Polymethyl methacrylate</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - surgery</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Retrospective Studies</subject><subject>Seizures (Medicine)</subject><subject>Seizures - etiology</subject><subject>Skull - surgery</subject><subject>Statistical analysis</subject><subject>Stroke - etiology</subject><subject>Stroke - surgery</subject><subject>Surgery</subject><subject>Tertiary Care Centers</subject><subject>Titanium</subject><subject>Trauma</subject><subject>Traumatic brain injury</subject><subject>Young Adult</subject><issn>0028-3886</issn><issn>1998-4022</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkc1PwyAYh4nR6Py4ezJNPHfCS0vLcZmfiYkXPRPavV3QFiq0LvvvZZmfycKBAM_vR-Ah5JzRacYov6IUypSXpZhCIUUh9siESVmmGQXYJ5Of4yNyHMJrXHLO4JAccWAgIRMT8vA0DrXrMCSuSeZeW-P6VodhnTTedYlOntEPRvt1cu9CbwbdJsbG7Wv8wNb1xi6TuRvt4Nen5KDRbcCzr_mEvNzePM_v08enu4f57DGtM0lDqmVRCJ4LAblAKPMip1ndaCwlwiKvUMiizrXkFa0Ey6jGSpZQAWt4lTG-4PyEXG57e-_eRwyDenWjt_FKBbxgQCUrxS-11C0qYxs3eF13JtRqJpiA2M0hUukOaokWvW6dxcbE7X_8dAcfxwI7U-8M0G2g9i4Ej43qvenidypG1Uah2jhSG0dqqzBGLr7eN1YdLn4C384iMNsCK9cO6MNbO67Qq8i-Wbf6V5z-KVaCq2_Z_BPXcafm</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Prasad, G</creator><creator>Menon, Girish</creator><creator>Kongwad, Lakshman</creator><creator>Kumar, Vinod</creator><general>Wolters Kluwer India Pvt. 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methods</topic><topic>Developing Countries</topic><topic>Etiology</topic><topic>Etiology (Medicine)</topic><topic>Female</topic><topic>Fractures</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Infant</topic><topic>Infection</topic><topic>Infections</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Polymethyl methacrylate</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - surgery</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Retrospective Studies</topic><topic>Seizures (Medicine)</topic><topic>Seizures - etiology</topic><topic>Skull - surgery</topic><topic>Statistical analysis</topic><topic>Stroke - etiology</topic><topic>Stroke - surgery</topic><topic>Surgery</topic><topic>Tertiary Care Centers</topic><topic>Titanium</topic><topic>Trauma</topic><topic>Traumatic brain injury</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prasad, G</creatorcontrib><creatorcontrib>Menon, Girish</creatorcontrib><creatorcontrib>Kongwad, Lakshman</creatorcontrib><creatorcontrib>Kumar, Vinod</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Neurology India</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prasad, G</au><au>Menon, Girish</au><au>Kongwad, Lakshman</au><au>Kumar, Vinod</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Cranioplasty from a Tertiary Hospital in a Developing Country</atitle><jtitle>Neurology India</jtitle><addtitle>Neurol India</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>68</volume><issue>1</issue><spage>63</spage><epage>70</epage><pages>63-70</pages><issn>0028-3886</issn><eissn>1998-4022</eissn><abstract>Introduction: Although cranioplasty (CP) is a straightforward procedure, it may result in a significant number of complications. These include infections, seizures, intracranial hematomas, and others. Many reports have stated that early CP is associated with higher complications; however, more recent articles have contradicted this opinion. We intend to share our experience and results on outcomes of CP from our university hospital.
Materials and Methods: This is a 3-year retrospective analysis of patients undergoing CP. Demographic profile, etiology of decompressive craniectomy (DC), DC-CP interval, operative details, complications, and follow-up data were analyzed. Correlation of complications with timing of CP and other factors was studied to look for statistical significance.
Results: A
total of 93 cases were analyzed. The majority were traumatic and ischemic stroke etiologies. There were eight open/compound head injuries (HIs). Eleven were bilateral and the rest unilateral cases. The mean and median CP interval were 8.5 weeks (range 4-28 weeks) and 8 weeks, respectively. All patients received 48 h to up to 5 days of postoperative antibiotics. Ten complications (10.7%) were noted (including one death). Poor Glasgow Outcome Scale at CP was the only statistically significant factor associated with higher complication rates. There was no statistical difference with respect to gender, CP material, and etiology; however, early CP had slightly fewer complications.
Conclusion: Patients with poor neurological condition at the time of CP have a significantly higher risk of complications. Contrary to earlier reports, early CP (<12 weeks) was not associated with higher complications but rather fewer complications than delayed procedures. Adherence to a few simple steps may help reduce these complications.</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>32129246</pmid><doi>10.4103/0028-3886.279676</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Adolescent Adult Aged Analysis Antibiotics Child Child, Preschool Convulsions & seizures Decompressive Craniectomy - methods Developing Countries Etiology Etiology (Medicine) Female Fractures Health aspects Humans Infant Infection Infections Male Middle Aged Ostomy Patients Polymethyl methacrylate Postoperative Complications - etiology Postoperative Complications - surgery Reconstructive Surgical Procedures - methods Retrospective Studies Seizures (Medicine) Seizures - etiology Skull - surgery Statistical analysis Stroke - etiology Stroke - surgery Surgery Tertiary Care Centers Titanium Trauma Traumatic brain injury Young Adult |
| title | Outcomes of Cranioplasty from a Tertiary Hospital in a Developing Country |
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