?

DESTINY

2007 Neurology
? ICUs
32 patients

Clinical Question

Decompressive surgery (hemicraniectomy) for life-threatening massive cerebral infarction

Critical Appraisal

Critique

DESTINY showed that hemicraniectomy reduces mortality in large hemispheric stroke. With 32 patients included, the primary end point failed to demonstrate statistical superiority of hemicraniectomy, and the projected sample size was calculated to 188 patients. Despite this failure to meet the primary end point, the steering committee decided to terminate the trial in light of the results of the joint analysis of the 3 European hemicraniectomy trials.

Population
Stroke
Population Details
malignant MCA infarction
Intervention Arms

Decompressive Craniectomy
decompressive craniectomy

Control Arms

Standard Care

Primary Outcome
Survival with favourable neurology
Secondary Outcomes
A 50% reduction in mortality
P Value
0.9

Outcome Results

Not recorded