PMID- 36244277
OWN - NLM
STAT- MEDLINE
DCOM- 20221123
LR  - 20221123
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 31
IP  - 12
DP  - 2022 Dec
TI  - Decompressive hemicraniectomy for space-occupying brain infarction: Nationwide 
      population-based registry study.
PG  - 106831
LID - S1052-3057(22)00525-0 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2022.106831 [doi]
AB  - OBJECTIVE: We analyzed data from the Norwegian Stroke Registry (NSR) to study 
      access to and outcomes of decompressive hemicraniectomy for brain infarction in a 
      nationwide routine clinical setting. We also discretionary assessed whether the 
      outcomes were comparable with those achieved in randomized controlled trials 
      (RCTs), and whether the use was in accordance with guidelines. METHODS: The NSR 
      is a nationwide (population 5.3 million) clinical quality registry. We included 
      all stroke-cases operated in 2017 through 2019, and retrieved data on baseline 
      characteristics, treatment and functional outcome after three months 
      (dichotomized modified Rankin Scale score; favorable (0-3) or unfavorable (4-6)). 
      Crude treatment rates and the expected proportion of patients transferred from a 
      local hospital to a stroke-center for the operation were estimated, based on the 
      total population's distribution of residency. RESULTS: The 68 cases were 17 (25%) 
      women and 51 (75%) men with a median National Institute of Health Stroke Scale 
      (NIHSS) score on admission of 14.0 (inter-quartile range (IQR) 11.0) and a median 
      time from onset to hemicraniectomy of 34.3 (IQR 40.9) hours. The crude treatment 
      rate varied between regions from 0.29 to 1.40 operations per 100,000 population 
      per year, and the proportion transferred from a local hospital (50%) was lower 
      than expected (68%). A favorable outcome was achieved in 20/52 (38.5%) cases. 
      CONCLUSIONS: The findings indicate gender- and geographic-inequalities in access. 
      Among operated cases, outcomes were comparable with those reported from RCTs, and 
      the use in accordance with recommendations in the current guidelines from the 
      American Stroke Association.
CI  - Copyright (c) 2022. Published by Elsevier Inc.
FAU - Anke, Pablo
AU  - Anke P
AD  - Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso, 
      Norway.
FAU - Kjelsberg Pedersen, Lars
AU  - Kjelsberg Pedersen L
AD  - Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University 
      Hospital of North Norway, Tromso Norway.
FAU - Mathiesen, Ellisiv B
AU  - Mathiesen EB
AD  - Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso, 
      Norway; Department of Neurology, Dermatology and Rheumatology, University 
      Hospital of North Norway, Tromso, Norway.
FAU - Ingebrigtsen, Tor
AU  - Ingebrigtsen T
AD  - Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso, 
      Norway; Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, 
      University Hospital of North Norway, Tromso Norway; Australian Institute of 
      Health Innovation, Macquarie University, Sydney, Australia. Electronic address: 
      tor.ingebrigtsen@unn.no.
LA  - eng
PT  - Journal Article
DEP - 20221014
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - Treatment Outcome
MH  - *Stroke/diagnosis/surgery
MH  - Brain Infarction/surgery
MH  - Registries
MH  - *Decompressive Craniectomy/adverse effects
MH  - Infarction, Middle Cerebral Artery/surgery
OTO - NOTNLM
OT  - Acute stroke
OT  - Brain edema
OT  - Decompressive surgery
OT  - Outcome
OT  - Registry
COIS- Declaration of Competing Interest None
EDAT- 2022/10/17 06:00
MHDA- 2022/11/24 06:00
CRDT- 2022/10/16 18:21
PHST- 2022/09/19 00:00 [received]
PHST- 2022/10/09 00:00 [accepted]
PHST- 2022/10/17 06:00 [pubmed]
PHST- 2022/11/24 06:00 [medline]
PHST- 2022/10/16 18:21 [entrez]
AID - S1052-3057(22)00525-0 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2022.106831 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2022 Dec;31(12):106831. doi: 
      10.1016/j.jstrokecerebrovasdis.2022.106831. Epub 2022 Oct 14.