Health status and life satisfaction after decompressive craniectomy for malignant middle cerebral artery infarction.
OBJECTIVE
To study the long-term outcome in patients with malignant middle cerebral artery (MCA) infarction treated with decompressive craniectomy. The outcome is described in terms of survival, impairment, disabilities and life satisfaction.


METHODS
Patients were examined at a minimum of 1 year (mean 2.9, range 1-6) after the surgery and classified according to the Glasgow Outcome Scale (GOS), the National Institutes of Health Stroke scale (NIHSS), the Barthel Index (BI), the short-form health survey (SF-36) and the life satisfaction checklist (LiSat-11).


RESULTS
Eighteen patients were included. The long-term survival was 78%. The mean NIHSS score was 13.8 (range 6-20). No patient was left in a vegetative state. The mean BI was 63.9 (5-100). The SF-36 scores showed that the patients' view of their health was significantly lower in most items compared with that of a reference group. According to the LiSat checklist, 83% found their life satisfying/rather satisfying and 17% found their life rather dissatisfying/dissatisfying.


CONCLUSIONS
We conclude that the patients remained in an impaired neurological condition, but had fairly good insight into their limitations. Although their life satisfaction was lower compared with that of the controls, the majority felt that life in general could still be satisfying.
Skoglund
T S
TS
Department of Neurosurgery, Sahlgrenska University Hospital, Göteborg, Sweden. thomas.skoglund@vgregion.se
Eriksson-Ritzén
C
C
Sörbo
A
A
Jensen
C
C
Rydenhag
B
B
D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D023261:Glasgow Outcome Scale; D006304:Health Status; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000523:psychology* / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome