AUTHOR=Buffagni Daniel , Zamarron Alvaro , Melgosa Isabel , Gutierrez-Gonzalez Raquel 

TITLE=Long-term quality of life after decompressive craniectomy

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1222080

DOI=10.3389/fneur.2023.1222080

ISSN=1664-2295

ABSTRACT=Introduction: This study aims to assess the QoL in patients who have undergone DC for any pathology that has caused life-threatening intracranial hypertension. Likewise, it aims to evaluate QoL perceived by caregivers or external informants. Besides that, the last purpose is to determine which clinical or therapeutic factors could correlate with a better QoL.
Methods: A single-center cross-sectional study was designed. All patients over 18 years old who underwent a supratentorial DC at our department due to intracranial hypertension of any etiology, from January 2015 to December 2021, were retrospectively selected. Patients with incomplete follow-up (under one year from the event or those who died) or who declined to participate in the study were excluded. QoL was assessed with SF-36 and CAVIDACE scales. Correlation between clinical and therapeutic variables and SF-36 subscales was studied with Spearman’s correlation and the Mann-Whitney U tests.
Results: 55 consecutive patients were recruited: 22 patients died, 3 were missed for follow-up, and 15 declined to participate, so 15 subjects were finally included. Mean follow-up was 47 months (IQR 21.5-67.5) A significant reduction in “role physical” and “role emotional” subscales of SF-36 were observed compared with general population. According to caregivers, a significant reduction was assigned to “physical well-being” and “rights” domains. The “physical functioning” score was poorer in women, older patients, those with dominant hemisphere disease, those who required tracheostomy, and those with poor outcomes in the modified Rankin scale. A strong correlation was found between the QoL index at the CAVIDACE scale and the SF-36 subscales “physical functioning” and “role physical”.
Conclusion: Most patients and caregivers reported acceptable QoL after DC due to a life-threatening disease. A significant reduction in SF-36 sub-scales “role limitation due to physical problems” and “role limitation due to emotional problems” was referred by patients. According to caregivers’ QoL perception, only 25% of the survey’s participants showed low scores in the QoL index of the CAVIDACE scale. Only 26.7% of the patients showed mood disorders.