gms | German Medical Science

Objective: Although cranioplasty (CP) is considered to be a “simple” neurosurgical procedure, it is performed extensively different depending on institutional conventions. So far, no reliable data on surgery-related complications after CP are available. Here, we report the first interim analysis of the German Cranial Reconstruction Registry (GCRR) with regard to early surgery-related complications.

Methods: All patients with a complete data set included in the GCRR, aprospective multicenter database, were analyzed. Early complications during the in-patient stay, medical history, mortality rates and neurological outcome at discharge were evaluated. A multivariate logistic regression analysis was used to identify independent factors for the occurrence of complications.

Results: A total of 304 patients out of 351 registered in the GCRR were included. At least one complication during the initial hospital stay was declared in 75 patients (24.7%), a surgical revision was necessary in 27 patients (8.9%). The surgery-related mortality rate was 1.3%. Most common complications were subdural or epidural hematoma (38 cases), seizures (13), new symptomatic hydrocephalus (7), CSF-fistula and wound dehiscence (each 5). A multivariate regression analysis revealed duration of surgery (Odds ratio=OR=1.009; p=0.007), the preoperative mRS (OR=1.209; p=0.028) and a sinking-skin-flap (OR=2.287; p=0.029) as independent factors for early complications.

Conclusion: For the first time, we provide evidence-based multi-center results for this distinct patient group. Surgery related complications are common after CP and linked to specific pre-existing conditions and surgical skills. Upcoming analyses of the GCRR will further sharpen our understanding of this treatment."