Brief Review of the DECRA Trial— Cooper 2020

This is a brief audio review. In the article DECRA Trial published, 2020 by Cooper and Colleagues, The outcomes and key points are as noted: Decompressive craniectomy vs medical management was studied. Craniectomy mortality was not significantly improved or worsened compared to medical management, 6 month mortality 19% versus 18%, 12 month mortality 21% vs. 19%. Lower functional outcomes were noted in the decompressive craniectomy group at 6 months, Odds Ratio 1.84, P=0.03, 12 month functional outcomes noted fewer good outcomes ratio 0.33, P=0.03. Vegetative states were noted in craniectomy patients as well compared to other patients, ratio 5.12, p=0.04. There Intracranial pressure index was 11.5 versus 19.9, P<0.001. Decompressive craniectomy had fewer days in intensive care 3 vs. 18, P<0.001. This was a Randomized clinical trial with 155 patients who were patients with severe traumatic brain injury and elevated intracranial pressure; patients with elevated intracranial pressure of >20 millimeters of mercury for 15 minutes over a 1 hour period within the first 72 hours of care.

Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, Ponsford J, Seppelt I, Reilly P, Wiegers E, Wolfe R; DECRA Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group. Patient Outcomes at Twelve Months after Early Decompressive Craniectomy for Diffuse Traumatic Brain Injury in the Randomized DECRA Clinical Trial. J Neurotrauma. 2020 Mar 1;37(5):810-816. doi: 10.1089/neu.2019.6869. PMID: 32027212; PMCID: PMC7071071.