Efficacy of decompressive craniectomy on long-term functional outcomes in patients with severe acquired brain injury: a systematic review and meta-analysis.

IF 1.7 4区医学 Q4 NEUROSCIENCES

International Journal of Neuroscience Pub Date : 2026-08-01 Epub Date: 2026-06-06 DOI:10.1080/00207454.2026.2673871

Lingling Guo, Jinchao Zhao

{"title":"Efficacy of decompressive craniectomy on long-term functional outcomes in patients with severe acquired brain injury: a systematic review and meta-analysis.","authors":"Lingling Guo, Jinchao Zhao","doi":"10.1080/00207454.2026.2673871","DOIUrl":null,"url":null,"abstract":"Aim: To evaluate the efficacy of decompressive craniectomy (DC) on long-term functional outcomes in patients with severe acquired brain injury (ABI) through systematic review and meta-analysis.Methods: We conducted a systematic review and meta-analysis of studies from 2010 to 2025. Nine studies (5 RCTs and 4 cohorts) with 3866 patients were included after quality assessment. Analysis was performed using RevMan 5.4.Results: DC significantly improved functional outcomes at 12 months (OR = 3.63, 95% CI: 1.45-9.10) and reduced 12-month mortality (OR = 0.44, 95% CI: 0.21-0.90), despite high heterogeneity for mortality. No significant benefit was found for 6-month functional outcomes or complication rates. Subgroup analyses indicated that the survival benefit was more pronounced in Asian populations, and functional improvement was significant for both traumatic and non-TBI patients.Conclusions: DC provides significant long-term benefits for functional outcomes and survival in severe ABI patients, without increasing short-term complications. Its efficacy varies by ethnicity and etiology, suggesting a need for personalized treatment decisions.","PeriodicalId":14161,"journal":{"name":"International Journal of Neuroscience","volume":" ","pages":"1231-1240"},"PeriodicalIF":1.7000,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/00207454.2026.2673871","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/6/6 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Aim: To evaluate the efficacy of decompressive craniectomy (DC) on long-term functional outcomes in patients with severe acquired brain injury (ABI) through systematic review and meta-analysis.

Methods: We conducted a systematic review and meta-analysis of studies from 2010 to 2025. Nine studies (5 RCTs and 4 cohorts) with 3866 patients were included after quality assessment. Analysis was performed using RevMan 5.4.

Results: DC significantly improved functional outcomes at 12 months (OR = 3.63, 95% CI: 1.45-9.10) and reduced 12-month mortality (OR = 0.44, 95% CI: 0.21-0.90), despite high heterogeneity for mortality. No significant benefit was found for 6-month functional outcomes or complication rates. Subgroup analyses indicated that the survival benefit was more pronounced in Asian populations, and functional improvement was significant for both traumatic and non-TBI patients.

Conclusions: DC provides significant long-term benefits for functional outcomes and survival in severe ABI patients, without increasing short-term complications. Its efficacy varies by ethnicity and etiology, suggesting a need for personalized treatment decisions.

查看原文本刊更多论文

颅脑减压切除术对重度获得性脑损伤患者长期功能预后的影响：系统回顾和荟萃分析。

目的：通过系统综述和荟萃分析，评价颅脑减压术（DC）对重度获得性脑损伤（ABI）患者长期功能结局的影响。方法：我们对2010-2025年的研究进行了系统回顾和荟萃分析。质量评估后纳入9项研究（5个随机对照试验，4个队列），共3866例患者。使用RevMan 5.4进行分析。结果：DC显著改善了12个月的功能结局（OR = 3.63, 95% CI: 1.45-9.10），降低了12个月的死亡率（OR = 0.44, 95% CI: 0.21-0.90），尽管死亡率存在高度异质性。在6个月的功能结局或并发症发生率方面没有发现明显的益处。亚组分析表明，亚洲人群的生存获益更为明显，创伤性和非创伤性脑损伤患者的功能改善都很显著。结论：DC为严重ABI患者的功能结局和生存提供了显著的长期益处，没有增加短期并发症。其疗效因种族和病因而异，这表明需要个性化的治疗决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Neuroscience 医学-神经科学

CiteScore

5.10

自引率

0.00%

发文量

132

审稿时长

2 months

期刊介绍： The International Journal of Neuroscience publishes original research articles, reviews, brief scientific reports, case studies, letters to the editor and book reviews concerned with problems of the nervous system and related clinical studies, epidemiology, neuropathology, medical and surgical treatment options and outcomes, neuropsychology and other topics related to the research and care of persons with neurologic disorders. The focus of the journal is clinical and transitional research. Topics covered include but are not limited to: ALS, ataxia, autism, brain tumors, child neurology, demyelinating diseases, epilepsy, genetics, headache, lysosomal storage disease, mitochondrial dysfunction, movement disorders, multiple sclerosis, myopathy, neurodegenerative diseases, neuromuscular disorders, neuropharmacology, neuropsychiatry, neuropsychology, pain, sleep disorders, stroke, and other areas related to the neurosciences.