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Early or late cranioplasty following decompressive craniotomy for traumatic brain injury: A systematic review and meta-analysis

Authors :
Zheng, Feng
Xu, Hao
von Spreckelsen, Niklas
Stavrinou, Pantelis
Timmer, Marco
Goldbrunner, Roland
Cao, Fang
Ran, Qishan
Li, Gang
Fan, Ruiming
Zhang, Qiang
Chen, Wei
Yao, Shengtao
Krischek, Boris
Source :
Journal of International Medical Research; July 2018, Vol. 46 Issue: 7 p2503-2512, 10p
Publication Year :
2018

Abstract

Objective To evaluate the effectiveness of early (<3 months) cranioplasty (CP) and late CP (>3 months) on post-operative complications in patients receiving decompressive craniotomy (DC) for traumatic brain injury (TBI).Methods The Cochrane Library, PubMed and EMBASE databases were systematically searched for studies published prior to May 21, 2017. A meta-analysis examined post-operative overall complication rates, infection rates, subdural fluid collection and operating times according to early and late CP.Results Of the initial 1675 references, five studies, all cohort, involving a total of 413 patients, were selected for the review. There was no difference between early and late CP in post-operative overall complication rate (RR=0.68, 95%CI [0.36, 1.29]) and the post-operative infection rate (RR=0.50, 95%CI [0.20, 1.24]) in patients receiving DC for TBI. However, there was a significant difference in post-operative subdural effusion (RR=0.24, 95%CI [0.07, 0.78]) and mean operative time (mean difference = −33.02 min, 95%CI [−48.19, −17.84]) both in favour of early CP.Conclusions No differences were found between early and late CP in post-operative overall complications and procedural related infections in patients receiving DC for TBI, but early CP reduced the complication of subdural effusion and the mean operating time. These findings need to be confirmed by large, randomised controlled trials.

Details

Language :
English
ISSN :
03000605 and 14732300
Volume :
46
Issue :
7
Database :
Supplemental Index
Journal :
Journal of International Medical Research
Publication Type :
Periodical
Accession number :
ejs46047480
Full Text :
https://doi.org/10.1177/0300060518755148