{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:44:10Z","timestamp":1792395850014,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review aimed to assess the cost\u2010effectiveness of decompressive craniectomy (DC) in severe traumatic brain injury (TBI) patients by analyzing relevant economic studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors conducted a comprehensive search across multiple databases and included economic evaluation studies, clinical trials, observational studies, or modeling studies that focused on patients who underwent DC for severe TBI. The quality of included studies was assessed using the Drummond checklist, and potential publication bias was examined. Data on total hospital costs, quality\u2010adjusted life years (QALY), cost per QALY, and patient demographics were extracted and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The included studies were of moderate to high quality. Total hospital costs increased with a higher likelihood of unfavorable outcomes. A cost\u2013utility analysis demonstrated that DC led to a higher expected QALY gain compared to medical management. At 12 months, though, DC was the costlier option. In the Finnish cohort, the estimated cost of continued care ran to several times that of the initial admission, which raised the all\u2010in cost per QALY well above the figure for neurosurgical treatment alone. Cost\u2010effectiveness varied with the severity of TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DC may be cost\u2010effective in the management of severe TBI in selected patients, particularly those at lower risk of an unfavorable outcome, although the available evidence is limited and heterogeneous. That value falls as injury severity rises, and at the extreme end of severity the procedure is no longer cost\u2010effective. Decisions about DC in severe TBI therefore turn on both the expected clinical benefit and the cost, not on either alone. Longer follow\u2010up would help, since much of both the cost and the recovery in these patients accrues years after surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71748","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T05:15:51Z","timestamp":1788758151000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost\u2010Effectiveness of Decompressive Craniectomy in Severe Traumatic Brain Injury Patients: A Systematic Review of Economic Studies"],"prefix":"10.1002","volume":"16","author":[{"given":"William Andr\u00e9s","family":"Florez\u2010Perdomo","sequence":"first","affiliation":[{"name":"Department of Research Colombian Clinical Research Group in Neurocritical Care  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Sebasti\u00e1n Reyes","family":"Bello","sequence":"additional","affiliation":[{"name":"Department of Research Colombian Clinical Research Group in Neurocritical Care  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Rafael","family":"Moscote\u2010Salazar","sequence":"additional","affiliation":[{"name":"Department of Research Colombian Clinical Research Group in Neurocritical Care  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Chavda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosurgery and NeuroGenetics, Department of Clinical and Translational Medicine ChromoMed Institute  Santo Domingo Dominican Republic"},{"name":"Department of Neuroscience and Neurosurgical Surgery Neurotraumatology Clinic  New Mexico Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashif","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murtaja","family":"Satea","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, College of Medicine University of Warith Al\u2010Anbiyaa  Karbala Governorate Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Restrepo","sequence":"additional","affiliation":[{"name":"Department of Research Colombian Clinical Research Group in Neurocritical Care  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery All India Institute of Medical Sciences, Saket Nagar  Bhopal Madhya Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Ant Encarnacion","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Russian People's Friendship University, Named after Patrice Lumumba  Moscow Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukhammadjon","family":"Norov","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery Republican Specialized Scientific and Practical Medical Center of Neurosurgery  Tashkent Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norov","family":"Abdurakhmon","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery Republican Specialized Scientific and Practical Medical Center of Neurosurgery  Tashkent Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bipin","family":"Chaurasia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Neurosurgery Clinic  Birgunj Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000500"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.6.593"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282x20180016"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2021.1878556"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6933.901"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.12.056"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jme.26.5.323"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1102077"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.5.w909"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2018.71.1.12"},{"key":"e_1_2_11_12_1","first-page":"9780199665877","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond M. 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