Objective: The aim of the current study was to observe functional outcomes of patients undergoing
decompressive craniectomy (DC) for raised intracranial pressure (ICP) after blunt
head injury and to assess possible predictive factors. Methodology: This study was
a prospective cohort study which was conducted at Aga Khan University Hospital, Karachi
over a period of 2 years (January 2015–December 2016). Adult patients, aged between
15 and 65 years of both genders undergoing DC during the study period were selected.
Outcomes of DC were assessed at an interval of 3 months following injury using the
Glasgow outcome score. The data were analyzed on IBM statistics SPSS version 21. Results: Seventy-two patients underwent DC for raised and refractory ICP. Glasgow Outcome
Scale (GOS) at discharge, 1-month and 3-month follow-up were reported. GOS at 3-month
follow-up showed 21 patients (29.2%) patients had a good recovery, moderate disability
was reported in 16 patients (22.2%), and severe disability in 12 patients (16.7%),
persistent vegetative state was seen in five patients (6.9%). Eighteen patients had
in hospital mortality (25.0%). Tracheostomy and sphenoid fractures were found to be
negative predictors of good functional outcome. Conclusions: DC is associated with an in hospital mortality of 25.0%. Favorable outcomes were
seen in 51.4% patients. Tracheostomy and sphenoid fractures were negative predictors
of good functional outcome. The results are comparable to international literature.
Key-words:
Decompressive craniectomy - intracranial pressure - Traumatic head injury
