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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Geurts, Marjolein Hofmeijer, Jeannette Kappelle, L. Jaap Algra, Ale Van Der Worp, H. Bart Amelink, G. Johan |
| Organization | HAMLET Steering Committee |
| Description | Country affiliation: Netherlands Author Affiliation: Geurts M ( Department of Neurology and Neurosurgery, UMC Utrecht Stroke Center, Utrecht, The Netherlands. m.geurts-2@umcutrecht.nl) |
| Abstract | BACKGROUND AND PURPOSE: We assessed whether the effects of surgical decompression for space-occupying hemispheric infarction, observed at 1 year, are sustained at 3 years. METHODS: Patients with space-occupying hemispheric infarction, who were enrolled in the Hemicraniectomy After Middle cerebral artery infarction with Life-threatening Edema Trial within 4 days after stroke onset, were followed up at 3 years. Outcome measures included functional outcome (modified Rankin Scale), death, quality of life, and place of residence. Poor functional outcome was defined as modified Rankin Scale >3. RESULTS: Of 64 included patients, 32 were randomized to decompressive surgery and 32 to best medical treatment. Just as at 1 year, surgery had no effect on the risk of poor functional outcome at 3 years (absolute risk reduction, 1%; 95% confidence interval, -21 to 22), but it reduced case fatality (absolute risk reduction, 37%; 95% confidence interval, 14-60). Sixteen surgically treated patients and 8 controls lived at home (absolute risk reduction, 27%; 95% confidence interval, 4-50). Quality of life improved between 1 and 3 years in patients treated with surgery. CONCLUSIONS: In patients with space-occupying hemispheric infarction, the effects of decompressive surgery on case fatality and functional outcome observed at 1 year are sustained at 3 years. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com. Unique identifier: ISRCTN94237756. |
| ISSN | 00392499 |
| e-ISSN | 15244628 |
| Journal | Stroke |
| Issue Number | 9 |
| Volume Number | 44 |
| Language | English |
| Publisher | Lippincott Williams & Wilkins (on behalf of the American Heart Association) |
| Publisher Date | 2013-09-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Cerebral Infarction Surgery Decompression, Surgical Neurosurgical Procedures Quality Of Life Psychology Mortality Severity Of Illness Index Time Factors Comparative Study Randomized Controlled Trial Research Support, Non-u.s. Gov't Discipline Cardiology |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical) |
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