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New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy

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New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy. / Sauvigny, Thomas; Göttsche, Jennifer; Vettorazzi, Eik; Westphal, Manfred; Regelsberger, Jan.

In: WORLD NEUROSURG, Vol. 88, 04.2016, p. 519–525.e1.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Sauvigny, T, Göttsche, J, Vettorazzi, E, Westphal, M & Regelsberger, J 2016, 'New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy', WORLD NEUROSURG, vol. 88, pp. 519–525.e1. https://doi.org/10.1016/j.wneu.2015.10.072

APA

Sauvigny, T., Göttsche, J., Vettorazzi, E., Westphal, M., & Regelsberger, J. (2016). New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy. WORLD NEUROSURG, 88, 519–525.e1. https://doi.org/10.1016/j.wneu.2015.10.072

Vancouver

Sauvigny T, Göttsche J, Vettorazzi E, Westphal M, Regelsberger J. New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy. WORLD NEUROSURG. 2016 Apr;88:519–525.e1. https://doi.org/10.1016/j.wneu.2015.10.072

Bibtex

@article{a9f52bee75c649e9899ed1d46fa6de33,
title = "New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy",
abstract = "OBJECTIVE:Decompressive craniectomy (DC) is an established part of the management of patients with increased intracranial pressure due to malignant middle cerebral artery (MCA) infarction or traumatic brain injury (TBI). The aim of this study was to determine prognostic radiologic parameters regarding the functional outcome of patients with increased intracranial pressure (ICP) undergoing DC. Special focus was put on the potential differences between malignant MCA infarction and TBI.METHODS:A total of 113 patients were analyzed for their clinical course where preoperative and postoperative radiologic features in computed tomography (CT) scans were correlated to the clinical outcome assessed by the Glasgow Outcome Scale. The difference between presurgical and postsurgical midline shift (ΔMLS) and the ratio between the diameter of the affected and contralateral hemisphere (HDratio) in presurgical and postsurgical CT scans were calculated.RESULTS:ΔMLS (MCA infarction group) and postsurgical HDratio (TBI group) were found to be highly correlating with the clinical outcome on Spearman-correlation testing and underwent further analysis using a binary logistic regression model to evaluate their prognostic value on the outcome, which showed the predictive power of ΔMLS in malignant MCA infarction patients (odds ratio [OR] 0.715; confidence interval [CI] 0.551-0.865). Postsurgical HDratio correlated significantly (OR 0.620; CI 0.384-0.901) with the outcome in the TBI group.CONCLUSION:ΔMLS is an objectifiable parameter, predicting outcome in malignant MCA infarction. In contrast, ΔMLS was of no predictive value in TBI patients. Here postsurgical HDratio serves as a strong predictor of clinical outcome. We recommend applying postsurgical HDratio to TBI patients in order to estimate their clinical outcome and adjust treatment.",
author = "Thomas Sauvigny and Jennifer G{\"o}ttsche and Eik Vettorazzi and Manfred Westphal and Jan Regelsberger",
year = "2016",
month = apr,
doi = "10.1016/j.wneu.2015.10.072",
language = "English",
volume = "88",
pages = "519–525.e1",
journal = "WORLD NEUROSURG",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

RIS

TY - JOUR

T1 - New Radiologic Parameters Predict Clinical Outcome after Decompressive Craniectomy

AU - Sauvigny, Thomas

AU - Göttsche, Jennifer

AU - Vettorazzi, Eik

AU - Westphal, Manfred

AU - Regelsberger, Jan

PY - 2016/4

Y1 - 2016/4

N2 - OBJECTIVE:Decompressive craniectomy (DC) is an established part of the management of patients with increased intracranial pressure due to malignant middle cerebral artery (MCA) infarction or traumatic brain injury (TBI). The aim of this study was to determine prognostic radiologic parameters regarding the functional outcome of patients with increased intracranial pressure (ICP) undergoing DC. Special focus was put on the potential differences between malignant MCA infarction and TBI.METHODS:A total of 113 patients were analyzed for their clinical course where preoperative and postoperative radiologic features in computed tomography (CT) scans were correlated to the clinical outcome assessed by the Glasgow Outcome Scale. The difference between presurgical and postsurgical midline shift (ΔMLS) and the ratio between the diameter of the affected and contralateral hemisphere (HDratio) in presurgical and postsurgical CT scans were calculated.RESULTS:ΔMLS (MCA infarction group) and postsurgical HDratio (TBI group) were found to be highly correlating with the clinical outcome on Spearman-correlation testing and underwent further analysis using a binary logistic regression model to evaluate their prognostic value on the outcome, which showed the predictive power of ΔMLS in malignant MCA infarction patients (odds ratio [OR] 0.715; confidence interval [CI] 0.551-0.865). Postsurgical HDratio correlated significantly (OR 0.620; CI 0.384-0.901) with the outcome in the TBI group.CONCLUSION:ΔMLS is an objectifiable parameter, predicting outcome in malignant MCA infarction. In contrast, ΔMLS was of no predictive value in TBI patients. Here postsurgical HDratio serves as a strong predictor of clinical outcome. We recommend applying postsurgical HDratio to TBI patients in order to estimate their clinical outcome and adjust treatment.

AB - OBJECTIVE:Decompressive craniectomy (DC) is an established part of the management of patients with increased intracranial pressure due to malignant middle cerebral artery (MCA) infarction or traumatic brain injury (TBI). The aim of this study was to determine prognostic radiologic parameters regarding the functional outcome of patients with increased intracranial pressure (ICP) undergoing DC. Special focus was put on the potential differences between malignant MCA infarction and TBI.METHODS:A total of 113 patients were analyzed for their clinical course where preoperative and postoperative radiologic features in computed tomography (CT) scans were correlated to the clinical outcome assessed by the Glasgow Outcome Scale. The difference between presurgical and postsurgical midline shift (ΔMLS) and the ratio between the diameter of the affected and contralateral hemisphere (HDratio) in presurgical and postsurgical CT scans were calculated.RESULTS:ΔMLS (MCA infarction group) and postsurgical HDratio (TBI group) were found to be highly correlating with the clinical outcome on Spearman-correlation testing and underwent further analysis using a binary logistic regression model to evaluate their prognostic value on the outcome, which showed the predictive power of ΔMLS in malignant MCA infarction patients (odds ratio [OR] 0.715; confidence interval [CI] 0.551-0.865). Postsurgical HDratio correlated significantly (OR 0.620; CI 0.384-0.901) with the outcome in the TBI group.CONCLUSION:ΔMLS is an objectifiable parameter, predicting outcome in malignant MCA infarction. In contrast, ΔMLS was of no predictive value in TBI patients. Here postsurgical HDratio serves as a strong predictor of clinical outcome. We recommend applying postsurgical HDratio to TBI patients in order to estimate their clinical outcome and adjust treatment.

U2 - 10.1016/j.wneu.2015.10.072

DO - 10.1016/j.wneu.2015.10.072

M3 - SCORING: Journal article

C2 - 26548831

VL - 88

SP - 519–525.e1

JO - WORLD NEUROSURG

JF - WORLD NEUROSURG

SN - 1878-8750

ER -