Analysis of the profile and clinical outcome of patients with malignant stroke undergoing decompressive craniectomy at a hospital in southern Ceará.

Abstract

Stroke is one of the leading causes of mortality and disability worldwide, with a significant impact on healthcare systems. Malignant middle cerebral artery stroke is a severe form of the disease, characterized by progressive cerebral edema and a high risk of death. Decompressive craniectomy has been used as a surgical strategy to reduce intracranial pressure and improve patient survival. Objective: To describe the epidemiological profile and clinical outcome of patients with malignant middle cerebral artery stroke undergoing decompressive craniectomy. Method: This is a retrospective, cross-sectional, quantitative documentary study conducted between January 2021 and December 2023. Medical records of 51 patients with malignant stroke undergoing decompressive craniectomy were analyzed. Sociodemographic variables, risk factors, hospital complications, and functional outcomes were assessed using statistical analysis in SPSS 26.0 software. Results: The majority of patients were male (56.9%), with a mean age of 63.1 years. The most prevalent risk factors were hypertension (66.7%), smoking (33.3%), and diabetes mellitus (21.6%). Most (84.3%) arrived at the hospital within 12 hours of symptom onset. The most frequent complications included pulmonary infection (43.1%) and delirium (15.7%). Functional evolution indicated that many patients maintained severe dependence at hospital discharge, despite the intervention. Conclusion: Decompressive craniectomy contributed to patient survival, but the high prevalence of complications and the persistence of disabilities reinforce the need for multidisciplinary follow-up and rehabilitation strategies to minimize sequelae and improve the quality of life of survivors.