ArticleBMJ neurology open2026
Long-term functional outcomes and caregiver burden in survivors after decompressive hemicraniectomy for malignant hemispheric infarction: a real-world experience from South India.
Article in BMJ neurology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Malignant hemispheric infarction (MHI) is associated with high early mortality when managed conservatively. Decompressive hemicraniectomy (DHC) improves survival, but long-term functional outcomes and caregiver burden in low-resource settings remain poorly characterised, particularly in India. This study aimed to evaluate long-term outcomes and caregiver burden among MHI survivors undergoing DHC at a tertiary care centre in South India. Methods: We conducted an ambispective study of adult patients who underwent DHC for MHI between 2018 and 2023 and had at least 6 months of follow-up. Functional outcome was assessed using the modified Rankin Scale (mRS) and caregiver burden was evaluated using the Zarit Burden Interview. Subgroup analyses were performed based on infarct lateralisation and timing of surgery. Logistic regression was used to identify predictors of a favourable functional outcome. Results: 66 patients (mean age 44±12.8 years; 80% male) were included, with a median follow-up of 2 years (IQR: 1-4). Overall mortality was 24.2% (n=16). Among the 50 survivors, 26 (52.0%) achieved a good functional outcome (mRS ≤3) and 13 (26.0%) achieved an excellent outcome (mRS ≤2). Infarct lateralisation did not significantly influence mortality or functional recovery. Although early surgery and higher admission Glasgow Coma Scale scores were associated with better outcomes in univariate analysis, these factors were not significant in multivariate models. Caregivers of patients with mRS >2 reported significantly higher burden, particularly in emotional, physical and social domains. Conclusions: DHC for MHI results in meaningful long-term survival and functional recovery in selected patients, regardless of hemisphere involvement. However, residual disability imposes a substantial caregiver burden. Stroke care pathways in resource-limited settings should incorporate comprehensive rehabilitation and long-term caregiver support.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.