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Jamali, Mohammad, Noorollahi, Mahyar, Mohammad Hosseini, Ehsan, Rahmanian, Abdolkarim, Sayari, Mohammad, Ghahramani, Sulmaz. (1404). Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study. سامانه مدیریت نشریات علمی, 50(7), 445-454. doi: 10.30476/ijms.2024.102797.3589
Mohammad Jamali; Mahyar Noorollahi; Ehsan Mohammad Hosseini; Abdolkarim Rahmanian; Mohammad Sayari; Sulmaz Ghahramani. "Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study". سامانه مدیریت نشریات علمی, 50, 7, 1404, 445-454. doi: 10.30476/ijms.2024.102797.3589
Jamali, Mohammad, Noorollahi, Mahyar, Mohammad Hosseini, Ehsan, Rahmanian, Abdolkarim, Sayari, Mohammad, Ghahramani, Sulmaz. (1404). 'Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study', سامانه مدیریت نشریات علمی, 50(7), pp. 445-454. doi: 10.30476/ijms.2024.102797.3589
Jamali, Mohammad, Noorollahi, Mahyar, Mohammad Hosseini, Ehsan, Rahmanian, Abdolkarim, Sayari, Mohammad, Ghahramani, Sulmaz. Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study. سامانه مدیریت نشریات علمی, 1404; 50(7): 445-454. doi: 10.30476/ijms.2024.102797.3589

Outcome of Ischemic Stroke Patients Following Decompressive Craniectomy: A Cohort Study

Iranian Journal of Medical Sciences
مقاله 2، دوره 50، شماره 7، مهر 2025، صفحه 445-454    اصل مقاله (375.89 K)
نوع مقاله: Original Article(s)
شناسه دیجیتال (DOI): 10.30476/ijms.2024.102797.3589
نویسندگان
Mohammad Jamali1؛ Mahyar Noorollahi1؛ Ehsan Mohammad Hosseini1؛ Abdolkarim Rahmanian1؛ Mohammad Sayari2؛ Sulmaz Ghahramani* 3
1Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
2Department of Mathematical Sciences and Research Methods Centre, Durham University, Durham DH13LE, UK
3Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
چکیده
Background: Decompressive craniectomy (DC) is effective in reducing mortality and improving outcomes in stroke patients. However, there is a need for a better understanding of the outcomes and complications of stroke, particularly in regions such as Iran, where comprehensive studies on DC outcomes are scarce. This study investigated the effects of DC in stroke patients. 
Methods: This cohort study was conducted at Nemazi Hospital in Shiraz, Iran, from 2018 to 2020. All patients aged over 18 years with ischemic stroke requiring DC were included using census sampling. Data on demographics, clinical history, and imaging findings were collected. Outcomes were assessed using the modified rankin scale (mRS), Glasgow outcome score extended (GOSE), and aphasia severity rating (ASR). 
Results: A total of 144 cerebral infarction patients underwent DC; 22 (15.3%) were lost to follow-up, and 67 (55%) of the remaining patients died either during hospitalization or within at least 6 months of follow-up. Patients over 60 years old (OR=0.152), those with a history of stroke (OR=0.227), and those with COVID-19 infection (OR=0.164) were associated with a decreased likelihood of survival. However, an increase in the Glasgow Coma Scale (GCS) score on admission was associated with an increased probability of survival (OR=1.199). The ordered logistic regression analysis showed that an increase in GCS score was associated with a higher probability of achieving better outcomes across all models: GOSE (OR=1.177), mRS (OR=0.839, with lower scores indicating better outcomes), and ASR (OR=1.354). The analysis showed that patients over 60 had a lower probability of achieving better outcomes in the GOSE model (OR=0.185) and were likely to have worse outcomes in the mRS model (OR=5.182).
Conclusion: These findings underscored the critical role of comorbidities (such as COVID-19 and prior stroke) and GCS scores in predicting patient survival and functional outcomes following DC. In particular, the higher mortality rates and poorer functional outcomes observed in older patients highlighted the need for careful consideration in this age group. 

تازه های تحقیق

Mohammad Jamali (Google Scholar)

Sulmaz Ghahramani (Google Scholar)

کلیدواژه‌ها
Ischemic stroke؛ Decompressive craniectomy؛ Patients؛ Iran
سایر فایل های مرتبط با مقاله
مراجع
  1. Katan M, Luft A. Global Burden of Stroke. Semin Neurol. 2018;38:208-11. doi: 10.1055/s-0038-1649503. PubMed PMID: 29791947.
  2. Collaborators GBDS. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:439-58. doi: 10.1016/S1474-4422(19)30034-1. PubMed PMID: 30871944; PubMed Central PMCID: PMCPMC6494974.
  3. Prvu Bettger J, McCoy L, Smith EE, Fonarow GC, Schwamm LH, Peterson ED. Contemporary trends and predictors of postacute service use and routine discharge home after stroke. J Am Heart Assoc. 2015;4. doi: 10.1161/JAHA.114.001038. PubMed PMID: 25713291; PubMed Central PMCID: PMCPMC4345857.
  4. Heiss WD. Malignant MCA Infarction: Pathophysiology and Imaging for Early Diagnosis and Management Decisions. Cerebrovasc Dis. 2016;41:1-7. doi: 10.1159/000441627. PubMed PMID: 26581023.
  5. Godoy D, Pinero G, Cruz-Flores S, Alcala Cerra G, Rabinstein A. Malignant hemispheric infarction of the middle cerebral artery. Diagnostic considerations and treatment options. Neurologia. 2016;31:332-43. doi: 10.1016/j.nrl.2013.02.009. PubMed PMID: 23601756.
  6. Guanci MM. Management of the Patient with Malignant Hemispheric Stroke. Crit Care Nurs Clin North Am. 2020;32:51-66. doi: 10.1016/j.cnc.2019.11.003. PubMed PMID: 32014161.
  7. Heiss WD. Malignant MCA Infarction: Pathophysiology and Imaging for Early Diagnosis and Management Decisions. Cerebrovasc Dis. 2016;41:1-7. doi: 10.1159/000441627. PubMed PMID: 26581023.
  8. Juttler E, Unterberg A, Woitzik J, Bosel J, Amiri H, Sakowitz OW, et al. Hemicraniectomy in older patients with extensive middle-cerebral-artery stroke. N Engl J Med. 2014;370:1091-100. doi: 10.1056/NEJMoa1311367. PubMed PMID: 24645942.
  9. Wijdicks EF, Sheth KN, Carter BS, Greer DM, Kasner SE, Kimberly WT, et al. Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:1222-38. doi: 10.1161/01.str.0000441965.15164.d6. PubMed PMID: 24481970.
  10. Yang MH, Lin HY, Fu J, Roodrajeetsing G, Shi SL, Xiao SW. Decompressive hemicraniectomy in patients with malignant middle cerebral artery infarction: A systematic review and meta-analysis. Surgeon. 2015;13:230-40. doi: 10.1016/j.surge.2014.12.002. PubMed PMID: 25661677.
  11. Wei H, Jia FM, Yin HX, Guo ZL. Decompressive hemicraniectomy versus medical treatment of malignant middle cerebral artery infarction: a systematic review and meta-analysis. Biosci Rep. 2020;40. doi: 10.1042/BSR20191448. PubMed PMID: 31854446; PubMed Central PMCID: PMCPMC6944664.
  12. Rahmanian A, Seifzadeh B, Razmkon A, Petramfar P, Kivelev J, Alibai EA, et al. Outcome of decompressive craniectomy in comparison to nonsurgical treatment in patients with malignant MCA infarction. Springerplus. 2014;3:115. doi: 10.1186/2193-1801-3-115. PubMed PMID: 24711983; PubMed Central PMCID: PMCPMC3977016.
  13. Mohan Rajwani K, Crocker M, Moynihan B. Decompressive craniectomy for the treatment of malignant middle cerebral artery infarction. Br J Neurosurg. 2017;31:401-9. doi: 10.1080/02688697.2017.1329518. PubMed PMID: 28604106.
  14. Lindeskog D, Lilja-Cyron A, Kelsen J, Juhler M. Long-term functional outcome after decompressive suboccipital craniectomy for space-occupying cerebellar infarction. Clin Neurol Neurosurg. 2019;176:47-52. doi: 10.1016/j.clineuro.2018.11.023. PubMed PMID: 30522035.
  15. Shah A, Almenawer S, Hawryluk G. Timing of Decompressive Craniectomy for Ischemic Stroke and Traumatic Brain Injury: A Review. Front Neurol. 2019;10:11. doi: 10.3389/fneur.2019.00011. PubMed PMID: 30740085; PubMed Central PMCID: PMCPMC6355668.
  16. Cannarsa GJ, Simard JM. Decompressive Craniectomy for Stroke: Who, When, and How. Neurol Clin. 2022;40:321-36. doi: 10.1016/j.ncl.2021.11.009. PubMed PMID: 35465878.
  17. Dower A, Mulcahy M, Maharaj M, Chen H, Lim CED, Li Y, et al. Surgical decompression for malignant cerebral oedema after ischaemic stroke. Cochrane Database Syst Rev. 2022;11:CD014989. doi: 10.1002/14651858.CD014989.pub2. PubMed PMID: 36385224; PubMed Central PMCID: PMCPMC9667531.
  18. Ayling OGS, Alotaibi NM, Wang JZ, Fatehi M, Ibrahim GM, Benavente O, et al. Suboccipital Decompressive Craniectomy for Cerebellar Infarction: A Systematic Review and Meta-Analysis. World Neurosurg. 2018;110:450-9. doi: 10.1016/j.wneu.2017.10.144. PubMed PMID: 29104155.
  19. Aguilar-Fuentes V, Orozco-Puga P, Jimenez-Ruiz A. The Glasgow Coma Scale: 50-year anniversary. Neurol Sci. 2024;45:2899-901. doi: 10.1007/s10072-024-07432-9. PubMed PMID: 38436790.
  20. Kwon S, Hartzema AG, Duncan PW, Min-Lai S. Disability measures in stroke: relationship among the Barthel Index, the Functional Independence Measure, and the Modified Rankin Scale. Stroke. 2004;35:918-23. doi: 10.1161/01.STR.0000119385.56094.32. PubMed PMID: 14976324.
  21. Wilson JT, Pettigrew LE, Teasdale GM. Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: guidelines for their use. J Neurotrauma. 1998;15:573-85. doi: 10.1089/neu.1998.15.573. PubMed PMID: 9726257.
  22. Khalili H, Niakan A, Ghaffarpasand F. Effects of cerebrolysin on functional recovery in patients with severe disability after traumatic brain injury: A historical cohort study. Clin Neurol Neurosurg. 2017;152:34-8. doi: 10.1016/j.clineuro.2016.11.011. PubMed PMID: 27871029.
  23. Kagan A, Winckel J, Black S, Duchan JF, Simmons-Mackie N, Square P. A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners. Top Stroke Rehabil. 2004;11:67-83. doi: 10.1310/CL3V-A94A-DE5C-CVBE. PubMed PMID: 14872401.
  24. Vahedi K, Vicaut E, Mateo J, Kurtz A, Orabi M, Guichard JP, et al. Sequential-design, multicenter, randomized, controlled trial of early decompressive craniectomy in malignant middle cerebral artery infarction (DECIMAL Trial). Stroke. 2007;38:2506-17. doi: 10.1161/STROKEAHA.107.485235. PubMed PMID: 17690311.
  25. Chua AE, Buckley BS, Lapitan M, Jamora R. Hemicraniectomy for malignant middle cerebral artery infarction (HeMMI): a randomized controlled clinical trial of decompressive surgery with standardized medical care versus standardized medical care alone. Acta Med Philipp. 2015;49:28-33.
  26. Dasenbrock HH, Robertson FC, Vaitkevicius H, Aziz-Sultan MA, Guttieres D, Dunn IF, et al. Timing of Decompressive Hemicraniectomy for Stroke: A Nationwide Inpatient Sample Analysis. Stroke. 2017;48:704-11. doi: 10.1161/STROKEAHA.116.014727. PubMed PMID: 28108618.
  27. Zhao J, Su YY, Zhang Y, Zhang YZ, Zhao R, Wang L, et al. Decompressive hemicraniectomy in malignant middle cerebral artery infarct: a randomized controlled trial enrolling patients up to 80 years old. Neurocrit Care. 2012;17:161-71. doi: 10.1007/s12028-012-9703-3. PubMed PMID: 22528280.
  28. Bansal H, Chaudhary A, Singh A, Paul B, Garg R. Decompressive craniectomy in malignant middle cerebral artery infarct: An institutional experience. Asian J Neurosurg. 2015;10:203-6. doi: 10.4103/1793-5482.161191. PubMed PMID: 26396607; PubMed Central PMCID: PMCPMC4553732.
  29. Das S, Mitchell P, Ross N, Whitfield PC. Decompressive Hemicraniectomy in the Treatment of Malignant Middle Cerebral Artery Infarction: A Meta-Analysis. World Neurosurg. 2019;123:8-16. doi: 10.1016/j.wneu.2018.11.176. PubMed PMID: 30500591.
  30. Hofmeijer J, Amelink GJ, Algra A, van Gijn J, Macleod MR, Kappelle LJ, et al. Hemicraniectomy after middle cerebral artery infarction with life-threatening Edema trial (HAMLET). Protocol for a randomised controlled trial of decompressive surgery in space-occupying hemispheric infarction. Trials. 2006;7:29. doi: 10.1186/1745-6215-7-29. PubMed PMID: 16965617; PubMed Central PMCID: PMCPMC1570365.
  31. Juttler E, Schwab S, Schmiedek P, Unterberg A, Hennerici M, Woitzik J, et al. Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY): a randomized, controlled trial. Stroke. 2007;38:2518-25. doi: 10.1161/STROKEAHA.107.485649. PubMed PMID: 17690310.
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