Evidence map›Paper›PMID 39836205›Full record

SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Surgical intervention in traumatic brain injury: a systematic review and meta-analysis of decompressive craniotomy.

Mubarak Algahtany, Amit Kumar, Malik Algahtany, Maan Alqahtani, Musaab Alnaami, Aws Algahtany, Majed Aldehri, Ibrahim Alnaami

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

8 authors.

Mubarak AlgahtanyDivision of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Amit KumarDepartment of Laboratory Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Malik AlgahtanyMedical Student, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Maan AlqahtaniMedical Student, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Musaab AlnaamiMedical Student, College of Medicine, Batarji Medical College, Abha, Saudi Arabia.
Aws AlgahtanyMedical Student, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Majed AldehriDepartment of Anatomy, College of Medicine, King Khalid University, 8082, 62523, Abha, Saudi Arabia. maldehri@kku.edu.sa.
Ibrahim AlnaamiDivision of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.

Funding

Deanship of Research and Graduate studies at King Khalid University RGP2/529/45
6 · The paper itself

Abstract

backgroundTraumatic brain injury (TBI) is considered a major cause of death globally, resulting from trauma. Decompressive craniectomy (DC) may improve functional outcomes in patients with TBI and its associated complications. This study was designed to determine safety and efficacy of DC in improving clinical outcomes in TBI patients compared to standard therapy.

methodsA systematic search was conducted across six electronic databases to identify relevant randomized controlled trials (RCTs) examining decompressive craniotomy (DC) and traumatic brain injury (TBI) from database inception until March 2021. The pooled risk ratio was estimated for categorical outcomes, while the pooled standardized mean difference with a 95% confidence interval was calculated for continuous outcomes. Statistical analysis software, including RevMan 5.4 and STATA version 17, was employed to perform this meta-analysis. The protocol for this study is registered with the OSF registry, ensuring transparency and reproducibility.

resultsA total of 656 studies were screened, and five RCTs involving 665 subjects (334 in the DC group and 331 in the control group) were included in this meta-analysis. Our meta-analysis revealed a non-significant trend towards a higher rate of favorable clinical outcomes in subjects who underwent DC compared to those in the medical treatment (MT) group (risk ratio (RR) 1.20, 95% confidence interval (CI) 0.70 to 2.08, P = 0.50). In contrast, the mortality rate was significantly lower in patients treated with DC compared to those receiving MT alone (RR 0.58, 95% CI 0.47 to 0.73, P < 0.001). Additionally, intracranial pressure (ICP) levels were significantly lower in subjects who underwent DC compared to those receiving MT alone (standardized mean difference (SMD): - 0.87, 95% CI - 1.58 to - 0.16, P = 0.02). Furthermore, there was a statistically significant reduction in the duration of stay in the DC group compared to the MT alone group (SMD: - 1.18, 95% CI - 1.49 to - 0.86, P < 0.001).

conclusionThis study presents evidence suggesting that DC is linked to a lower mortality rate, decreased ICP, and shorter hospital stays among patients with moderate to severe TBI. However, it did not show a significant impact on improving favorable clinical outcomes.

Indexed as

Brain Injuries, TraumaticDecompressive CraniectomyHumansRandomized Controlled Trials as TopicTreatment OutcomeCerebral perfusion pressure (CPP)Decompressive craniotomyIntracranial pressure (ICP)Randomized control trial (RCTs)Traumatic brain injury

Identifiers

PMID39836205

What OpenQuestion holds

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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.