RESCUEicp
Decompressive Craniectomy for Refractory Intracranial Hypertension
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 408 patients with TBI and refractory raised ICP, late-tier craniectomy reduced 6-month mortality compared with medical management, at the cost of more vegetative state and severe disability.
N
408
Schéma
International multicentre RCT (52 centres, 20 countries; UK-coordinated)
Critère
Extended Glasgow Outcome Score at 6 months
Pertinence
2
RésultatMortality 26.9% vs 48.9%; more vegetative state and severe disability among survivors.
Hutchinson PJ, et al. N Engl J Med. 2016;375(12):1119-1130. 10.1056/NEJMoa1605215
Discussion et critique
Last-tier therapy with explicit survival-vs-quality trade-off; goals of care must be aligned.