Evidence map›Paper›PMID 27406817›Full record

ArticleNeurocritical care2016

Patient Age and the Outcomes after Decompressive Hemicraniectomy for Stroke: A Nationwide Inpatient Sample Analysis.

Hormuzdiyar H Dasenbrock, Faith C Robertson, M Ali Aziz-Sultan, Donovan Guittieres, Rose Du, Ian F Dunn, William B Gormley

Abstract read
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In one paragraph

Article in Neurocritical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Hemorrhagic transformation following a malignant middle cerebral artery infarction.Journal of cerebrovascular and endovascular neurosurgery · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Hormuzdiyar H DasenbrockCushing Neurosurgery Outcomes Center, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Faith C RobertsonCushing Neurosurgery Outcomes Center, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
M Ali Aziz-SultanCushing Neurosurgery Outcomes Center, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Donovan GuittieresDepartment of Neurosurgery, Brigham and Women's Hospital,Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Rose DuCushing Neurosurgery Outcomes Center, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Ian F DunnCushing Neurosurgery Outcomes Center, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
William B GormleyCushing Neurosurgery Outcomes Center, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. wgormley@partners.org.
Brigham and Women's Hospital · USHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDecompressive hemicraniectomy (DHC) for space-occupying cerebral infarction in older adults remains controversial, and there are limited nationwide data evaluating the outcomes after craniectomy for stroke by patient age.

methodsPatients who underwent DHC for ischemic stroke were extracted from the Nationwide Inpatient Sample (2002-2011). Multivariable logistic regression examined in-hospital mortality and a poor outcome (death, tracheostomy and gastrostomy, or discharge to institutional care). Covariates included year of admission, comorbidities, severity indices, and treatment variables (including the timing of decompression).

resultsCraniectomy was performed in 1673 patients: 62.4 % were aged 18-60 years, 20.6 % aged 61-70 years, and 17.0 % aged greater than 70 years. DHC was associated with reduced adjusted odds of in-hospital death compared with medical treatment alone among patients with cerebral edema in all age categories, including those older than 70 years (p ≤ 0.008). However, among surgical patients, the adjusted odds of mortality were significantly greater for patients aged 61-70 (30.7 %, p = 0.02) and greater than 70 years (34.5 %, p = 0.02), but not different for patients aged 51-60 (22.8 %), compared to those aged 18-50 years (19.7 %). The adjusted odds of a poor outcome also increased significantly with age, particularly for patients greater than 60 years.

conclusionIn this nationwide analysis, DHC was associated with reduced mortality regardless of patient age, including among those aged greater than 70 years. However, patients aged greater than 60 years treated surgically experienced higher odds of mortality (32.4 %), discharge to institutional care (47.1 %), and a poor outcome (77.0 %) compared with younger patients.

Indexed as

AdolescentAdultAgedAged, 80 and overAge FactorsBrain IschemiaCerebral InfarctionDecompressive CraniectomyFemaleHospital MortalityHumansInpatientsMaleMiddle AgedOutcome Assessment, Health CareStrokeAgeCerebral infarctionDecompressive hemicraniectomyHemicraniectomyIschemic strokeMiddle cerebral arteryNationwide inpatient sample

Identifiers

PMID27406817
OpenAlexW2473952368

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.