Evidence map›Paper›PMID 30569269›Full record

Observational studyNeurocritical care2019

Decompressive Hemicraniectomy in Elderly Patients With Space-Occupying Infarction (DECAP): A Prospective Observational Study.

Jan Rahmig, Sigrid Wöpking, Eric Jüttler, Lorenz Uhlmann, Ronald Limprecht, Jessica Barlinn, Gabriele Schackert, Heinz Reichmann, Hauke Schneider

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurocritical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

9 authors.

Jan RahmigDepartment of Neurology, University Hospital, Technische Universität Dresden, Dresden, Germany.
Sigrid WöpkingDepartment of Neurology, University Hospital, Technische Universität Dresden, Dresden, Germany.
Eric JüttlerDepartment of Neurology, Ostalb-Klinikum Aalen, Aalen, Germany.
Lorenz UhlmannDepartment Medical Biometry, Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany.
Ronald LimprechtDepartment Medical Biometry, Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Heidelberg, Germany.
Jessica BarlinnDepartment of Neurology, University Hospital, Technische Universität Dresden, Dresden, Germany.
Gabriele SchackertDepartment of Neurosurgery, University Hospital, Technische Universität Dresden, Dresden, Germany.
Heinz ReichmannDepartment of Neurology, University Hospital, Technische Universität Dresden, Dresden, Germany.
Hauke SchneiderMedical Faculty, Technische Universität Dresden, Dresden, Germany. hauke.schneider@uniklinikum-augsburg.de.ORCID http://orcid.org/0000-0002-9641-0922

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDecompressive hemicraniectomy improves survival rates and functional outcome in patients with space-occupying middle cerebral artery (MCA) infarction. We sought to determine clinical outcomes in elderly patients with MCA infarction treated with hemicraniectomy and to identify factors associated with functional outcome.

methodsWe performed a prospective, single-center observational study aiming to include patients aged ≥ 61 years with large MCA infarction treated with hemicraniectomy. The primary endpoint was the functional outcome according to modified Rankin Scale (mRS) score at 6 months after hemicraniectomy. Secondary endpoints included outcome measures at 12 months. A pooled analysis of individual patient data from the single-center cohort and a DESTINY 2 trial subgroup was performed to identify factors associated with functional status at 12 months.

resultsWe included 40 MCA infarction patients who underwent hemicraniectomy between 2012 and 2017 at our university hospital (median [IQR] patient age 64 [62-67] years, National Institutes of Health Stroke Scale score 17 [16-21]). The dominant hemisphere was affected in 22/40 patients. Hemicraniectomy was performed within 31 [23-53] h of symptom onset. At 6 months after hemicraniectomy, 6/40 patients (15%) were moderately or moderately severely disabled (mRS score 3 or 4), 19 (47.5%) severely disabled (mRS score 5), and 15 (37.5%) had died. Compared to surgically treated DESTINY 2 patients, the single-center patients less likely exhibited favorable functional outcome at 6 months (mRS scores 0-4; odds ratio 0.239 [95% CI 0.082-0.696]). Case-fatality rate at 12 months was 43%. In a pooled analysis including 79 patients from DECAP and DESTINY 2, no significant associations of baseline and treatment factors with the clinical status at 12 months were observed.

conclusionsIn this single-center cohort of elderly patients with space-occupying MCA infarction and decompressive hemicraniectomy, the probability for survival without severe disability was low. Lethality at 6 and 12 months was comparable to previously reported data from a randomized trial.

Indexed as

Decompressive CraniectomyAgedAge FactorsFemaleHumansInfarction, Middle Cerebral ArteryMaleMiddle AgedProspective StudiesQuality of LifeRecovery of FunctionTime FactorsTreatment OutcomeDecompressive surgeryHemicraniectomyPooled analysisProspective observational studySpace-occupying infarctionStroke

Identifiers

PMID30569269

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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.