Does decompressive craniectomy improve outcomes in patients with diffuse traumatic brain injury?

D James Cooper and Jeffrey V Rosenfeld
Med J Aust 2011; 194 (9): . || doi: 10.5694/j.1326-5377.2011.tb03053.x
Published online: 2 May 2011

New results from an Australian collaborative randomised trial will change practice

Every year in Australia, 1000 people are admitted to intensive care units with severe traumatic brain injury, mostly as a result of motor vehicle accidents.1 Despite high standards of prehospital and medical care, 50% of these people either die or survive with severe lifelong disability.2 Most of the survivors with severe disability are young men aged in their mid 20s;2 they cannot return to work and will never be able to live independently. The cost of severe traumatic brain injury in human terms is huge, and in economic terms has been recently independently calculated to be $4.8 billion every year in Australia.1 In the United States, the annual economic burden of traumatic brain injury is $60 billion.3

  • D James Cooper1,2
  • Jeffrey V Rosenfeld1,2,2

  • 1 Alfred Hospital, Melbourne, VIC.
  • 2 Monash University, Melbourne, VIC.


Competing interests:

We had prominent roles in the design, conduct and publication of the DECRA trial. The DECRA trial was supported by grants from the NHMRC, the Transport Accident Commission of Victoria (Victorian Trauma Foundation and Victorian Neurotrauma Initiative), the Intensive Care Foundation, and the Western Australian Institute for Medical Research. D James Cooper is an NHMRC Practitioner Fellow and is also supported by two other NHMRC research project grants that are funding current randomised multicentre trials in traumatic brain injury (POLAR trial and EPO-TBI trial). He received consulting fees from Neuren Pharmaceuticals in 2007 for trial design advice relating to a new pharmaceutical drug for treating traumatic brain injury.


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