Evidence map›Paper›PMID 39112817›Full record

SynthesisNeurocritical care2025

Decompressive Craniectomy with or Without Dural Closure: Systematic Review and Meta-analysis.

Henrique L Lepine, Gabriel Semione, Raphael G Povoa, Gustavo de Oliveira Almeida, David Abraham, Eberval G Figueiredo

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

6 authors.

Henrique L LepineFaculty of Medicine of the University of São Paulo, University of São Paulo School of Medicine, São Paulo, Brazil.
Gabriel SemioneUniversity of West of Santa Catarina, Joaçaba, Santa Catarina, Brazil.
Raphael G PovoaFaculty of Medicine of the University of São Paulo, University of São Paulo School of Medicine, São Paulo, Brazil.
Gustavo de Oliveira AlmeidaFederal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
David AbrahamFederal University of Amazonas, Manaus, Amazonas, Brazil.
Eberval G FigueiredoDivision of Neurosurgery, University of São Paulo, Street Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil. ebgadelha@yahoo.com.ORCID 0000-0001-7754-4178

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Decompressive craniectomy is used to alleviate intracranial pressure in cases of traumatic brain injury and stroke by removing part of the skull to allow brain expansion. Traditionally, this procedure is followed by a watertight dural suture, although evidence supporting this method is not strong. This meta-analysis examines the feasibility of the open-dura (OD) approach versus the traditional closed-dura (CD) technique with watertight suturing. A systematic review and comparative meta-analysis were conducted on OD and CD dural closure techniques. Medline, Embase, and Cochrane were searched for relevant trials. The primary end point was the rate of complications, with specific analyses for infection and cerebrospinal fluid (CSF) leaks. Mortality, poor neurological outcomes, and operation duration were also assessed. Odds ratios with 95% confidence intervals (CIs) were calculated using a random-effects model. Following a comprehensive search, 930 studies were screened, from which four studies and a total of 368 patients were ultimately selected. The primary outcome analysis showed a reduced likelihood of complications in the OD group when compared with the CD group (368 patients, odds ratio 0.54 [95% CI 0.32-0.90]; I

Indexed as

Brain Injuries, TraumaticDecompressive CraniectomyDura MaterPostoperative ComplicationsStrokeSuture TechniquesCerebrospinal Fluid LeakHumansDecompressive craniectomyDural closureMeta-analysisTraumatic brain injury

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.