Nationwide study of decompressive surgery for malignant
supratentorial infarction in the Czech Republic: utilization
and outcome predictors

J 2010

Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors

BAR, Michal, Robert MIKULÍK, David SKOLOUDIK, Daniel CZERNY, Radim LIPINA et. al.

Základní údaje

Originální název

Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors

Autoři

BAR, Michal (203 Česká republika, garant), Robert MIKULÍK (203 Česká republika, domácí), David SKOLOUDIK (203 Česká republika), Daniel CZERNY (203 Česká republika), Radim LIPINA (203 Česká republika), Lukas KLECKA (203 Česká republika), Vilém JURÁŇ (203 Česká republika), Jan MRACEK (203 Česká republika), Denisa VONDRACKOVA (203 Česká republika), Lumír HRABÁLEK (203 Česká republika), Richard BRZEZNY (203 Česká republika) a Jan DIENELT (203 Česká republika)

Vydání

Journal of Neurosurgery, ROLLING MEADOWS, AMER ASSOC NEUROLOGICAL SURGEONS, 2010, 0022-3085

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 2.739

Kód RIV

RIV/00216224:14110/10:00058960

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.3171/2009.10.JNS09888

UT WoS

000282244700035

Klíčová slova anglicky

malignant ischemic stroke; decompressive surgery; utilization; predictors; Czech Republic; survey

Příznaky

Mezinárodní význam

Změněno: 22. 4. 2013 17:23, Soňa Böhmová

Anotace

V originále

Object. Decompressive surgery within 48 hours in patients younger than 60 years of age reduces mortality and morbidity from malignant supratentorial infarction. The goal of this study was to characterize the utilization of decompressive surgery in the Czech Republic in 2006. Methods. This nationwide study was undertaken from September to December 2007 using a questionnaire sent to all neurosurgery departments in the Czech Republic. Diagnosis of brain infarction and decompressive surgery was based on discharge codes. Patient data were retrieved from hospital charts. Favorable outcome was defined as a modified Rankin scale score <= 4 on the day of discharge from the hospital. Results. Data were obtained from 15 of the 16 neurosurgery departments in the Czech Republic (94%) and from 39 patients (11 female [28%]). The average patient age was 52 +/- 14 years (11 patients > 60), median time to surgery was 48 hours (interquartile range [IQR] 26-67 hours; 15 patients > 48 hours), median National Institutes of Health Stroke Scale score was 22 (IQR 16-30), median infarct volume was 341 cm(3) (IQR 243-375 cm(3)), mean shift from the midline was 9.9 +/- 4.1 mm, median duration of hospitalization was 19 days (IQR 13-30 days), and mean bone flap surface area was 75 cm(2) (IQR 70-97 cm(2)). A favorable outcome was achieved in 19 patients (49%). The median number of procedures per site in 2006 was 1.5 (range 0-13 procedures). Five sites (31%) serving one-third of the entire population did not perform any decompressive surgery. No variable was a significant predictor of outcome in a multiple regression model. Conclusions. In 2006 decompressive surgery was underutilized and occurred late in the clinical course in the Czech Republic. Revision of national guidelines is necessary to incorporate the latest data and ensure that the patients who can benefit most receive treatment.

Citovat

BAR, Michal, Robert MIKULÍK, David SKOLOUDIK, Daniel CZERNY, Radim LIPINA, Lukas KLECKA, Vilém JURÁŇ, Jan MRACEK, Denisa VONDRACKOVA, Lumír HRABÁLEK, Richard BRZEZNY a Jan DIENELT. Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors. Journal of Neurosurgery. ROLLING MEADOWS: AMER ASSOC NEUROLOGICAL SURGEONS, 2010, roč. 113, č. 4, s. 897-900. ISSN 0022-3085. Dostupné z: https://dx.doi.org/10.3171/2009.10.JNS09888.

@article{921598,
   author = {Bar, Michal and Mikulík, Robert and Skoloudik, David and Czerny, Daniel and Lipina, Radim and Klecka, Lukas and Juráň, Vilém and Mracek, Jan and Vondrackova, Denisa and Hrabálek, Lumír and Brzezny, Richard and Dienelt, Jan},
   article_location = {ROLLING MEADOWS},
   article_number = {4},
   doi = {http://dx.doi.org/10.3171/2009.10.JNS09888},
   keywords = {malignant ischemic stroke; decompressive surgery; utilization; predictors; Czech Republic; survey},
   language = {eng},
   issn = {0022-3085},
   journal = {Journal of Neurosurgery},
   title = {Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors},
   volume = {113},
   year = {2010}
}

TY  - JOUR
ID  - 921598
AU  - Bar, Michal - Mikulík, Robert - Skoloudik, David - Czerny, Daniel - Lipina, Radim - Klecka, Lukas - Juráň, Vilém - Mracek, Jan - Vondrackova, Denisa - Hrabálek, Lumír - Brzezny, Richard - Dienelt, Jan
PY  - 2010
TI  - Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors
JF  - Journal of Neurosurgery
VL  - 113
IS  - 4
SP  - 897-900
EP  - 897-900
PB  - AMER ASSOC NEUROLOGICAL SURGEONS
SN  - 00223085
KW  - malignant ischemic stroke
KW  - decompressive surgery
KW  - utilization
KW  - predictors
KW  - Czech Republic
KW  - survey
N2  - Object. Decompressive surgery within 48 hours in patients younger than 60 years of age reduces mortality and morbidity from malignant supratentorial infarction. The goal of this study was to characterize the utilization of decompressive surgery in the Czech Republic in 2006. Methods. This nationwide study was undertaken from September to December 2007 using a questionnaire sent to all neurosurgery departments in the Czech Republic. Diagnosis of brain infarction and decompressive surgery was based on discharge codes. Patient data were retrieved from hospital charts. Favorable outcome was defined as a modified Rankin scale score <= 4 on the day of discharge from the hospital. Results. Data were obtained from 15 of the 16 neurosurgery departments in the Czech Republic (94%) and from 39 patients (11 female [28%]). The average patient age was 52 +/- 14 years (11 patients > 60), median time to surgery was 48 hours (interquartile range [IQR] 26-67 hours; 15 patients > 48 hours), median National Institutes of Health Stroke Scale score was 22 (IQR 16-30), median infarct volume was 341 cm(3) (IQR 243-375 cm(3)), mean shift from the midline was 9.9 +/- 4.1 mm, median duration of hospitalization was 19 days (IQR 13-30 days), and mean bone flap surface area was 75 cm(2) (IQR 70-97 cm(2)). A favorable outcome was achieved in 19 patients (49%). The median number of procedures per site in 2006 was 1.5 (range 0-13 procedures). Five sites (31%) serving one-third of the entire population did not perform any decompressive surgery. No variable was a significant predictor of outcome in a multiple regression model. Conclusions. In 2006 decompressive surgery was underutilized and occurred late in the clinical course in the Czech Republic. Revision of national guidelines is necessary to incorporate the latest data and ensure that the patients who can benefit most receive treatment.
ER  -

BAR, Michal, Robert MIKULÍK, David SKOLOUDIK, Daniel CZERNY, Radim LIPINA, Lukas KLECKA, Vilém JURÁŇ, Jan MRACEK, Denisa VONDRACKOVA, Lumír HRABÁLEK, Richard BRZEZNY a Jan DIENELT. Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors. \textit{Journal of Neurosurgery}. ROLLING MEADOWS: AMER ASSOC NEUROLOGICAL SURGEONS, 2010, roč.~113, č.~4, s.~897-900. ISSN~0022-3085. Dostupné z: https://dx.doi.org/10.3171/2009.10.JNS09888.

Podrobný výpis o publikaci