ISSN: 1859 - 2872
Evaluating the complications of following cranioplasty: Incidence and relative factors
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Abstract
Objective: To evaluate the complications of cranioplasty after decompressive craniectomy and identify the association of these complications with some risk factors. Subject and method: Retrospective cohort study of 202 patients from August 2018 to January 2021, who had undergone decompressive craniectomy followed by cranioplasty at 108 Military Central Hospital. All patients were followed up to 6 months after cranioplasty and complications were recorded both by imaging and clinically. The major complications were recorded and evaluated in relation to a number of risk factors: Reason for craniectomy, comorbidities (hypertension, diabetes mellitus, anticoagulation), location of cranioplasty, duration from decompressive craniectomy to cranioplasty. Algorithms used for analysis include Student's t-test, Chi-square tests and Fisher's exact tests. Confidence intervals were calculated as the 95% CI. Result: The overall postoperative complication rate was 23.26%. The common complications included: Infection (6.44%), graft collapse (6.44%), seizures (6.44%), bleeding (3.46%). The early cranioplasties (within 3 months after decompressive craniectomy) and disturbance of cerebro - spinal fluid circulation were risk factors for increased postoperative complication rate (p<0.05). Some factors related to common complications: Early cranioplasty (< 3 months) was related to infection and graft collapse with p<0.05, late cranioplasty was associated with postcranioplasty seizure (p=0.007). The disturbance of spinal fluid circulation was associated with postcranioplasty seizure and bone flap resorption (p<0.05). Conclusion: Although cranioplasty is a simple surgical procedure, it is usually associated with a relatively high complication rate. Control of a patient’s risk factors and early recognition of complications may help practitioners avoid the exhaustive list of complications.
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References
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