Introduction: The objective of the study was to assess the quality of life of patients who underwent Decompressive Craniectomy (DC) for head injury and satisfaction of the caregivers with the outcomes.

Methods: This was a cross-sectional study conducted at a tertiary care urban center in Paksitan. All the patients with severe traumatic brain injury (TBI) who underwent DC and survived > 6 months were included in the study. Outcomes were assessed using two scoring systems, the Extended Glasgow Outcome Scale (GOSE) and Quality of Life After Traumatic Brain Injury (QOLIBRI) scale. The proforma was translasted and validated into the national language. Patient caregivers were interviewed to ask if they would opt for DC in a similar situation in future.

Results: The study included 40 patients; 35 males (88%) and 5 females (12%). The mean age of the study population was 26.5 (±9.5). The mean GCS at presentation was 8.34 ± 3.22. Median follow-up was 12 months year (6-18 months). The mean GOSE was 5.35 ±1.9, which correlates with an unfavorable outcome. The mean QOLIBRI score was 59.6 ± 21.3. However, family members of 38 (95%) patients were content with their decision to consent for DC in their patients. Pearson’s correlation for different domains of QOLIBRI and GOSE scales was statistically significant for all the parameters, except social relationship.

Conclusions: Mean QOLIBRI score of DC patients was 59.65± 21.27. Most care-takers (95%) were satisfied with their decision to consent for DC. Patient reported HRQOL assessment is necessary to assess the impact of TBI.

Patient Care: Helping in decision making of care givers

Learning Objectives: Quality of life after decompressive craniectomy is not that great but most care takers still satisfy with their decision

References: 1. Chesnut RM, Marshall LF, Klauber MR, et al. The role of secondary brain injury in determining outcome from severe head injury. J Trauma. 1993;34(2):216-222. doi:10.1097/00005373-199302000-00006. 2. Jennett B, Lancet MB-T, 1975 undefined. Assessment of outcome after severe brain damage: a practical scale. Elsevier. https://www.sciencedirect.com/science/article/pii/S0140673675928305. Accessed February 21, 2018. 3. Waqas M, Shamim MS, Enam SF, et al. Predicting outcomes of decompressive craniectomy: use of Rotterdam Computed Tomography Classification and Marshall Classification. Br J Neurosurg. 2016;30(2):258-263. doi:10.3109/02688697.2016.1139047. 4. Shamim M, Qadeer M, Murtaza G, … SE-J of, 2011 undefined. Emergency department predictors of tracheostomy in patients with isolated traumatic brain injury requiring emergency cranial decompression. thejns.org. http://thejns.org/doi/abs/10.3171/2011.7.JNS101829. Accessed February 21, 2018. 5. Waqas M, Bakhshi S, Shamim M, Neuroradiology SA-J of, 2016 undefined. Radiological prognostication in patients with head trauma requiring decompressive craniectomy: Analysis of optic nerve sheath diameter and Rotterdam CT Scoring. Elsevier.