Citation

Svoboda N, Benes V, Netuka D, Sokol M, Langová K, Májovský M. Ces. Slov. Neurol. Neurochir. 2019; 82(6): 670-676.

Copyright

(Copyright © 2019, Česká Lekařská Společnost J.E. Purkyně)

DOI

10.14735/amcsnn2019670

PMID

unavailable

Abstract

AIM: Gunshot wound to the head is one of the most severe injuries with high morbidity and mortality. Appropriately indicated extensive surgical treatment leads to improved patient prognosis. Thus, the evaluation of preoperative factors that would predict patients' prognosis is of high importance at the time of admission to the hospital.

METHODS: A retrospective analysis of the results of patients with gunshot head wounds hospitalized in the Military University Hospital in Prague during the period 2000-2018 was performed. Epidemiological data; Injury cause, type, and motive; Glasgow Coma Scale (GCS) on admission; CT scan findings; therapeutic approach; and clinical outcome according to the Glasgow Outcome Score Extended (GOSE) were evaluated and statistically analyzed.

RESULTS: 81 patients were enrolled in the study. Out of these 81 patients, 71 (88%) were injured in a civilian and 10 (12%) in a military setting. Mean GCS on admission was 5.8 (3-15). We operated on 18 patients. Mean GOSE after surgery was 2.8 (1-8). Patients with an overpenetration type of injury, with low GCS value on admission, with a higher number of injured brain lobes and with a bullet trajectory crossing the midsagittal and/or midcoronal plane had statistically significantly worse outcome (P ≤ 0.0001).

CONCLUSION: GCS on admission, injury cause and motive, and CT findings proved to be significantly important predictive factors. Chosen therapeutic approach should reflect these factors as they correlate with patient's prognosis. © 2019, Czech Medical Association J.E. Purkyne. All rights reserved.

Language: cs

Keywords

human; Suicide; prognosis; head injury; Traumatic brain injury; hospitalization; major clinical study; army; gunshot injury; bullet; retrospective study; epidemiological data; Gunshot; computer assisted tomography; Glasgow coma scale; university hospital; Article; Glasgow outcome scale; Wounds; predictive value; clinical outcome; Military medicine