DECRA
Decompressive Craniectomy in Diffuse Traumatic Brain Injury
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 155 patients with severe diffuse TBI and refractory raised ICP, early bifrontal craniectomy worsened 6-month functional outcome versus standard care.
N
155
Schéma
Multicentre RCT, ANZ
Critère
Extended Glasgow Outcome Score at 6 months
Pertinence
2
RésultatOR 1.84 for worse functional outcome (p=0.03); similar mortality.
Cooper DJ, et al. N Engl J Med. 2011;364(16):1493-1502. 10.1056/NEJMoa1102077
Discussion et critique
Tempered enthusiasm for early craniectomy; refractory ICP alone is not enough.