Validation of the Baragwanath mortality prediction score for cerebral gunshot wounds: the Pietermaritzburg experience

  • V. Y. Kong
  • G. V. Oosthuizen
  • B. Sartorious
  • J. L. Bruce
  • G. L. Laing
  • R. Weale
  • D. L. Clarke
Original Article



Cerebral gunshot wounds (GSW) are highly lethal injuries. To date, only one clinical scoring system to predict mortality in a developing world setting has been described. This is the Baragwanath mortality prediction score (“ABC”: admission blood pressure, brain matter spillage and consciousness level).

Materials and methods

We performed a retrospective review of prospectively entered data for a cohort of patients with isolated cerebral GSWs over a 5-year period (January 2010–December 2014) in our institution. We aimed to validate the Baragwanath ABC mortality prediction score in our population.


During the 5-year study period, 102 patients with isolated cerebral GSWs were reviewed, 22% (22/102) of which died. Based on the total ABC score (1–5), the mortality was 0% for 1, 21% for 2, 67% for 3, 92% for 4, and 100% for 5. The ABC score has a sensitivity of 82% (95% CI 60–95%), specificity of 96% (95% CI 89–99%), PPV of 86% (95% CI 66–96%) and NPV of 95% (95% CI 86–99%).


The Baragwanath mortality prediction score accurately predicts non survival of patients with a cerebral GSW in our patient cohort. Further validation studies in other populations are required before this system can be widely adopted.


Gunshot wounds Prediction score Mortality 


Compliance with ethical standards

Conflict of interest

Authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • V. Y. Kong
    • 1
  • G. V. Oosthuizen
    • 1
  • B. Sartorious
    • 1
  • J. L. Bruce
    • 1
  • G. L. Laing
    • 1
  • R. Weale
    • 2
  • D. L. Clarke
    • 1
    • 3
  1. 1.Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, Nelson Mandela School of MedicineUniversity of KwaZulu NatalDurbanSouth Africa
  2. 2.Department of General SurgeryWessex DeaneryWinchesterUK
  3. 3.Department of SurgeryUniversity of the WitwatersrandJohannesburgSouth Africa

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