Universität zu Köln

Sauvigny, Thomas, Giese, Henrik, Hoehne, Julius, Schebesch, Karl Michael, Henker, Christian, Strauss, Andreas, Beseoglu, Kerim ORCID: 0000-0001-5671-6831, von Spreckelsen, Niklas, Hampl, Jurgen A., Walter, Jan, Ewald, Christian, Krigers, Aleksandrs ORCID: 0000-0002-0950-426X, Petr, Ondra, Butenschoen, Vicki M., Krieg, Sandro M. ORCID: 0000-0003-4050-1531, Wolfert, Christina ORCID: 0000-0003-0093-9256, Gaber, Khaled, Mende, Klaus Christian, Bruckner, Thomas, Sakowitz, Oliver, Lindner, Dirk, Regelsberger, Jan and Mielke, Dorothee (2022). A multicenter cohort study of early complications after cranioplasty: results of the German Cranial Reconstruction Registry. J. Neurosurg., 137 (2). S. 591 - 599. ROLLING MEADOWS: AMER ASSOC NEUROLOGICAL SURGEONS. ISSN 1933-0693

Full text not available from this repository.

Abstract

OBJECTIVE Cranioplasty (CP) is a crucial procedure after decompressive craniectomy and has a significant impact on neurological improvement. Although CP is considered a standard neurosurgical procedure, inconsistent data on surgery-related complications after CP are available. To address this topic, the authors analyzed 502 patients in a prospective multicenter database (German Cranial Reconstruction Registry) with regard to early surgery-related complications. METHODS Early complications within 30 days, medical history, mortality rates, and neurological outcome at discharge according to the modified Rankin Scale (mRS) were evaluated. The primary endpoint was death or surgical revision within the first 30 days after CP. Independent factors for the occurrence of complications with or without surgical revision were identified using a logistic regression model. RESULTS Traumatic brain injury (TBI) and ischemic stroke were the most common underlying diagnoses that required CP. In 230 patients (45.8%), an autologous bone flap was utilized for CP; the most common engineered materials were titanium (80 patients [15.9%]), polyetheretherketone (57[11.4%]), and polymethylmethacrylate (57[11.4%]). Surgical revision was necessary in 45 patients (9.0%), and the overall mortality rate was 0.8% (4 patients). The cause of death was related to ischemia in 2 patients, diffuse intraparenchymal hemorrhage in 1 patient, and cardiac complications in 1 patient. The most frequent causes of surgical revision were epidural hematoma (40.0% of all revisions), new hydrocephalus (22.0%), and subdural hematoma (13.3%). Preoperatively increased mRS score (OR 1.46, 95% CI 1.08-1.97, p = 0.014) and American Society of Anesthesiologists Physical Status Classification System score (OR 2.89, 95% CI 1.42-5.89, p = 0.003) were independent predictors of surgical revision. Ischemic stroke, as the underlying diagnosis, was associated with a minor rate of revisions compared with TBI (OR 0.18, 95% CI 0.06-0.57, p = 0.004). CONCLUSIONS The authors have presented class II evidence-based data on surgery-related complications after CP and have identified specific preexisting risk factors. These results may provide additional guidance for optimized treatment of these patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sauvigny, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Giese, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoehne, Julius UNSPECIFIED UNSPECIFIED UNSPECIFIED Schebesch, Karl Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Henker, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Strauss, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Beseoglu, Kerim UNSPECIFIED orcid.org/0000-0001-5671-6831 UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hampl, Jurgen A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Walter, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Ewald, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Krigers, Aleksandrs UNSPECIFIED orcid.org/0000-0002-0950-426X UNSPECIFIED Petr, Ondra UNSPECIFIED UNSPECIFIED UNSPECIFIED Butenschoen, Vicki M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krieg, Sandro M. UNSPECIFIED orcid.org/0000-0003-4050-1531 UNSPECIFIED Wolfert, Christina UNSPECIFIED orcid.org/0000-0003-0093-9256 UNSPECIFIED Gaber, Khaled UNSPECIFIED UNSPECIFIED UNSPECIFIED Mende, Klaus Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruckner, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Sakowitz, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Lindner, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Regelsberger, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Mielke, Dorothee UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-693510
DOI:	10.3171/2021.9.JNS211549
Journal or Publication Title:	J. Neurosurg.
Volume:	137
Number:	2
Page Range:	S. 591 - 599
Date:	2022
Publisher:	AMER ASSOC NEUROLOGICAL SURGEONS
Place of Publication:	ROLLING MEADOWS
ISSN:	1933-0693
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DECOMPRESSIVE CRANIECTOMY; PREDICTORS; HEMICRANIECTOMY; OUTCOMES; SURGERY; STROKE; IMPACT; RISK Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69351