First Report of a Multicenter Prospective Registry of Cranioplasty in the United Kingdom and Ireland
Authors: Fountain Daniel M , Henry Jack , Honeyman Susan , O’Connor Paul , Sekhon Priya , Piper Rory J , Edlmann Ellie , Martin Michael , Whiting Gemma , Turner Carole , Mee Harry , Joannides Alexis J , Kolias Angelos G , Hutchinson Peter J ,   UK Cranial Reconstruction Registry (UKCRR) Collaborative, Williams Adam , Sinha Ajay , Leggate Alex , Belli Antonio , Bahl Anuj , McMahon Catherine , Tolias Christos , Holsgrove Daniel , O’Brien David , Bulters Diederik , George Edward St , Critchley Giles , James Greg , Akram Harith , Pollock Jonathan , Prasad Manjunath , Ganau Mario , Wilson Mark , Hossain-Ibrahim Mohammed , Bodkin Peter , Whitfield Peter , Mathew Ryan K , Joshi Shabin , Achawal Shailendra , Harrisson Stuart , Smith Stuart , Lawrence Tim , Al-Tamimi Yahia , Committee Steering , Bell Anthony , Shaw Simon , Brennan Paul M , Anderson Ian ,   British Neurosurgical Trainee Research Collaborative (BNTRC), Jamjoom Aimun A B , Shoakazemi Alireza , Khan Amad , Kadhim Ammar , Edwards-Bailey Andrew , Bjornson Anna , Roylance Anthony , Zafar Arif , Nabi Asad , Baig Mirza Asfand , Chari Aswin , Yannoulias Basil , Burford Charlotte , Akhunbay-Fudge Christopher , Millward Christopher P , Hill Ciaran , Barone Damiano , Stastna Daniela , Hajra Debasish , Dasgupta Debayan , Ferguson Debbie , Viaroli Edoardo , Toman Emma , Solomou Georgios , Jung Josephine , Ekert Justyna , Yakoub Kamal M , Nozad Lava , Haley Mark , Petric Marko , Khan Mehdi , Akhbari Melika , Amoo Michael , Hollingworth Milo , Naushahi Mohammad , Fadelalla Mohammed , Waqar Mueez , Khan Muhammad , El Sheikh Mustafa , Abdulla Mutwakil , McNulty Nicola , Ghimire Prajwal , Moon Richard , Venturini Sara , Lammy Simon , Bandyopadhyay Soham , Karavasili Vanessa , SinghAlg Varinder , Raptopoulos Vasileios , Soon Wai Cheong , Singleton Will 
Published: May 2021

Abstract

BACKGROUND
There are many questions that remain unanswered regarding outcomes following cranioplasty including the timing of cranioplasty following craniectomy as well as the material used.

OBJECTIVE
To establish and evaluate 30-d outcomes for all cranial reconstruction procedures in the United Kingdom (UK) and Ireland through a prospective multicenter cohort study.

METHODS
Patients undergoing cranioplasty insertion or revision between June 1, 2019 and November 30, 2019 in 25 neurosurgical units were included. Data collected include demographics, craniectomy date and indication, cranioplasty material and date, and 30-d outcome.

RESULTS
In total, 313 operations were included, consisting of 255 new cranioplasty insertions and 58 revisions. Of the new insertions, the most common indications for craniectomy were traumatic brain injury (n = 110, 43%), cerebral infarct (n = 38, 15%), and aneurysmal subarachnoid hemorrhage (n = 30, 12%). The most common material was titanium (n = 163, 64%). Median time to cranioplasty was 244 d (interquartile range 144-385), with 37 new insertions (15%) within or equal to 90 d. In 30-d follow-up, there were no mortalities. There were 14 readmissions, with 10 patients sustaining a wound infection within 30 d (4%). Of the 58 revisions, the most common reason was due to infection (n = 33, 59%) and skin breakdown (n = 13, 23%). In 41 (71%) cases, the plate was removed during the revision surgery.

CONCLUSION
This study is the largest prospective study of cranioplasty representing the first results from the UK Cranial Reconstruction Registry, a first national registry focused on cranioplasty with the potential to address outstanding research questions for this procedure.