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Neurosurgical Review

, Volume 35, Issue 3, pp 429–436 | Cite as

Prognostic factors in civilian gunshot wounds to the head: a series of 110 surgical patients and brief literature review

  • Patricia B. Ambrosi
  • Marcelo M. Valença
  • Hildo Azevedo-Filho
Original Article

Abstract

This study was carried out to evaluate the early results and the prognostic factors affecting the outcome during the in-hospital stay of 110 patients with civilian gunshot wounds to the head admitted at the Hospital of Restauração, Recife, Brazil. Penetrating injury (66%) was the most prevalent type of wound encountered in the present series. Twelve of the 110 (10.9%) patients presented a unilateral dilated pupil at the admission. Motor impairment was present in 24/110 (21.8%) patients. Intracerebral hematoma was present in 36/110 (32.7%) and there were 15/110 (13%) patients with cerebrospinal fluid fistula. Eleven of 110 patients developed meningitis and in 9/110 intracranial abscesses occurred. Nine of 110 patients developed deep venous thrombosis, 11/110 had urinary infection, and coagulopathy was detected in 8/110. Following the surgical procedure, 27/110 (24.5%) patients died during their hospital stay. When the two groups, survivors and non-survivors, were compared, there were significant statistical differences and the univariate analysis identified five preoperative predictors of a poor outcome following surgery: age over 40 years (odds ratios (OR) 5.4, 95% CI 1.73–16.82); presence of unilateral pupil dilatation (OR 5.5, 95% CI 1.641–18.13); low (≤8) Glasgow coma score on admission (OR 6.50, 95% CI 2.27–18.60), presence of intracranial hematoma (OR 3.0, 95% CI 1.21–7.34), and respiratory infection (OR 4.8, 95% CI 1.75–13.47). Thus, (a) age of the patient (juvenile/young age), (b) high preoperative Glasgow coma score, (c) lack of pupil abnormalities, and (d) absence of intracerebral hematoma are predictors of a good prognosis.

Keywords

Gunshot wound Head injury Outcome Penetrating brain injury 

Notes

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Patricia B. Ambrosi
    • 1
  • Marcelo M. Valença
    • 1
  • Hildo Azevedo-Filho
    • 1
  1. 1.Department of Neurological Surgery, Hospital of RestauraçãoUniversity of PernambucoRecifeBrazil

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