Decompressive Craniectomy in Diffuse Traumatic Brain Injury - ICU

Results Primary outcome was worse in the craniectomy group odds ratio 1.84; 95%[CI], 1.05 to 3.24; P=0.03Unfavorable outcomes occurred in 51 patients (70%) in the craniectomygroup and in 42 patients (51%) in the standard care group (odds ratio, 2.21;95% CI, 1.14 to 4.26;P = 0.02After adjustment for pre- specified covariates, the results were similar forthe score on the Extended Glasgow Outcome Scale (adjusted odds ratiofor a lower score in the craniectomy group, 1.66; 95% CI, 0.94 to 2.94; P =0.08) and for the risk of an unfavorable outcome (adjusted odds ratio, 2.31;95% CI, 1.10 to 4.83;P = 0.03).After posthoc adjustment for pupil reactivity at baseline (Table 1), thebetween group differences were no longer significant for the score on theExtended Glasgow Outcome Scale (adjusted odds ratio, 1.53; 95% CI, 0.86to 2.73;P = 0.15) and for the risk of an unfavorable outcome (adjusted oddsratio, 1.90; 95% CI, 0.95 to3.79;P = 0.07).15