First Report of a Multicenter Prospective Registry of Cranioplasty in the United Kingdom and Ireland.
Autologous
Craniectomy
Cranioplasty
TBI
Titanium
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
16 08 2021
16 08 2021
Historique:
received:
27
08
2020
accepted:
29
04
2021
pubmed:
1
7
2021
medline:
26
11
2021
entrez:
30
6
2021
Statut:
ppublish
Résumé
There are many questions that remain unanswered regarding outcomes following cranioplasty including the timing of cranioplasty following craniectomy as well as the material used. To establish and evaluate 30-d outcomes for all cranial reconstruction procedures in the United Kingdom (UK) and Ireland through a prospective multicenter cohort study. Patients undergoing cranioplasty insertion or revision between June 1, 2019 and November 30, 2019 in 25 neurosurgical units were included. Data collected include demographics, craniectomy date and indication, cranioplasty material and date, and 30-d outcome. In total, 313 operations were included, consisting of 255 new cranioplasty insertions and 58 revisions. Of the new insertions, the most common indications for craniectomy were traumatic brain injury (n = 110, 43%), cerebral infarct (n = 38, 15%), and aneurysmal subarachnoid hemorrhage (n = 30, 12%). The most common material was titanium (n = 163, 64%). Median time to cranioplasty was 244 d (interquartile range 144-385), with 37 new insertions (15%) within or equal to 90 d. In 30-d follow-up, there were no mortalities. There were 14 readmissions, with 10 patients sustaining a wound infection within 30 d (4%). Of the 58 revisions, the most common reason was due to infection (n = 33, 59%) and skin breakdown (n = 13, 23%). In 41 (71%) cases, the plate was removed during the revision surgery. This study is the largest prospective study of cranioplasty representing the first results from the UK Cranial Reconstruction Registry, a first national registry focused on cranioplasty with the potential to address outstanding research questions for this procedure.
Sections du résumé
BACKGROUND
There are many questions that remain unanswered regarding outcomes following cranioplasty including the timing of cranioplasty following craniectomy as well as the material used.
OBJECTIVE
To establish and evaluate 30-d outcomes for all cranial reconstruction procedures in the United Kingdom (UK) and Ireland through a prospective multicenter cohort study.
METHODS
Patients undergoing cranioplasty insertion or revision between June 1, 2019 and November 30, 2019 in 25 neurosurgical units were included. Data collected include demographics, craniectomy date and indication, cranioplasty material and date, and 30-d outcome.
RESULTS
In total, 313 operations were included, consisting of 255 new cranioplasty insertions and 58 revisions. Of the new insertions, the most common indications for craniectomy were traumatic brain injury (n = 110, 43%), cerebral infarct (n = 38, 15%), and aneurysmal subarachnoid hemorrhage (n = 30, 12%). The most common material was titanium (n = 163, 64%). Median time to cranioplasty was 244 d (interquartile range 144-385), with 37 new insertions (15%) within or equal to 90 d. In 30-d follow-up, there were no mortalities. There were 14 readmissions, with 10 patients sustaining a wound infection within 30 d (4%). Of the 58 revisions, the most common reason was due to infection (n = 33, 59%) and skin breakdown (n = 13, 23%). In 41 (71%) cases, the plate was removed during the revision surgery.
CONCLUSION
This study is the largest prospective study of cranioplasty representing the first results from the UK Cranial Reconstruction Registry, a first national registry focused on cranioplasty with the potential to address outstanding research questions for this procedure.
Identifiants
pubmed: 34192745
pii: 6311972
doi: 10.1093/neuros/nyab220
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
518-526Subventions
Organisme : Medical Research Council
ID : MR/T005297/1
Pays : United Kingdom
Investigateurs
Adam Williams
(A)
Ajay Sinha
(A)
Alex Leggate
(A)
Antonio Belli
(A)
Anuj Bahl
(A)
Catherine McMahon
(C)
Christos Tolias
(C)
Daniel Holsgrove
(D)
David O'Brien
(D)
Diederik Bulters
(D)
Edward St George
(ES)
Giles Critchley
(G)
Greg James
(G)
Harith Akram
(H)
Jonathan Pollock
(J)
Manjunath Prasad
(M)
Mario Ganau
(M)
Mark Wilson
(M)
Mohammed Hossain-Ibrahim
(M)
Peter Bodkin
(P)
Peter Whitfield
(P)
Ryan K Mathew
(RK)
Shabin Joshi
(S)
Shailendra Achawal
(S)
Stuart Harrisson
(S)
Stuart Smith
(S)
Tim Lawrence
(T)
Yahia Al-Tamimi
(Y)
Steering Committee
(S)
Anthony Bell
(A)
Simon Shaw
(S)
Paul M Brennan
(PM)
Ian Anderson
(I)
Aimun A B Jamjoom
(AAB)
Alireza Shoakazemi
(A)
Amad Khan
(A)
Ammar Kadhim
(A)
Andrew Edwards-Bailey
(A)
Anna Bjornson
(A)
Anthony Roylance
(A)
Arif Zafar
(A)
Asad Nabi
(A)
Asfand Baig Mirza
(A)
Aswin Chari
(A)
Basil Yannoulias
(B)
Charlotte Burford
(C)
Christopher Akhunbay-Fudge
(C)
Christopher P Millward
(CP)
Ciaran Hill
(C)
Damiano Barone
(D)
Daniela Stastna
(D)
Debasish Hajra
(D)
Debayan Dasgupta
(D)
Debbie Ferguson
(D)
Edoardo Viaroli
(E)
Emma Toman
(E)
Georgios Solomou
(G)
Josephine Jung
(J)
Justyna Ekert
(J)
Kamal M Yakoub
(KM)
Lava Nozad
(L)
Mark Haley
(M)
Marko Petric
(M)
Mehdi Khan
(M)
Melika Akhbari
(M)
Michael Amoo
(M)
Milo Hollingworth
(M)
Mohammad Naushahi
(M)
Mohammed Fadelalla
(M)
Mueez Waqar
(M)
Muhammad Khan
(M)
Mustafa El Sheikh
(M)
Mutwakil Abdulla
(M)
Nicola McNulty
(N)
Prajwal Ghimire
(P)
Richard Moon
(R)
Sara Venturini
(S)
Simon Lammy
(S)
Soham Bandyopadhyay
(S)
Vanessa Karavasili
(V)
Varinder SinghAlg
(V)
Vasileios Raptopoulos
(V)
Wai Cheong Soon
(WC)
Will Singleton
(W)
Informations de copyright
© Congress of Neurological Surgeons 2021.