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Decompressive craniectomy (DC) after devastating brain injury (DBI) may influence the manner in which patients die, having implications for end-of-life care and organ donation. We performed a retrospective review of deaths following a non-traumatic DBI between 2008 and 2012. 160 patients were reviewed; 26 were treated with DC and 134 received standard care. There was no relationship between DC and mechanism of death, (OR 1.18, 95% CI 0.44-3.17). Prospective studies are required to confirm these preliminary finding. DC studies should report the mechanism of death.
Mécanismes du décès et craniectomie de décompression à la suite d’une lésion cérébrale non-traumatique. À la suite de lésions cérébrales sévères, la craniectomie de décompression (CD) peut influencer la façon dont les patients décèdent, en plus d’avoir une incidence sur les soins de fin de vie et le don d’organes. Nous avons ainsi mené une analyse rétrospective des décès survenus entre 2008 et 2012 à la suite de lésions cérébrales sévères non-traumatiques. Pour ce faire, nous avons passé en revue 160 dossiers de patients : 26 d’entre eux avaient été traités au moyen de la CD alors que 134 avaient bénéficié de soins standards. Aucun lien n’a été trouvé entre la CD et des mécanismes du décès (ratio d’incidence rapproché ou RIR=1,18 ; IC95% = 0,44-3,17). Des études prospectives sont donc nécessaires pour confirmer ces conclusions préliminaires. De plus, les études menées au sujet de la CD devraient veiller à signaler le mécanisme du décès en cause.
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