Risk factors for the prognosis of decompressive craniectomy combined with unilateral frontotemporal craniotomy and hematoma removaling for severe impact brain injury

Objective To analyze the risk factors for the prognosis of decompressive craniectomy combined with unilateral frontotemporal craniotomy hematoma removaling for severe impact brain injury. Methods Eighty patients with severe impact brain injury in People’s Hospital of Xinzhou from May 2014 to May 2019 were enrolled. According to the postoperative Glasgow outcome scale scores, they were divided into the good prognosis group (n=60) and the poor prognosis group (n=20). All patients underwent decompressive craniectomy + unilateral frontotemperal craniotomy for hematoma evacuation, the factors affecting the prognosis of patients were analyzed. Results The preoperative Glasgow coma scale scores of good prognosis group were significantly higher than those of the poor prognosis group(P<0.05). In good prognosis group, the amount of hematoma was less than 40 ml; operation time was generally within 6 h after injury; there was no postoperative complications, and the degree of midline shift was less than 0.5 cm; moreover the differences in the above indexes were significant between the two groups (P<0.05). Multivariate Logistic regression analysis showed that the timing of surgery, the degree of midline shift, and the amount of hematoma were independent risk factors for prognosis (P<0.05). Conclusions The timing of surgery, the degree of midline shift, and the amount of hematoma are independent risk factors for the prognosis of severe impact brain injury patients undergoing decompressive craniectomy combined with unilateral frontotemporal craniotomy hematoma removaling. Key words: Decompressive craniectomy; Unilateral frontotemporal craniotomy hematoma removaling; Severe brain injury