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Introduction Cerebral gunshot wounds are highly lethal and literature on the clinical scores for mortality prediction is limited. Materials and methods A retrospective study was undertaken over a 5-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa. A simplified clinical prediction score was developed based on clinical and/or physiological variables readily available in the resuscitation room. Results A total of 102 patients were included; 92% (94/102) were male and the mean age was 29 years; 22% (22/102) died during the admission. The presence of visible brain matter (odds ratio 12.4, P = 0.003) and motor score less than 5 (odds ratio 89.6, P  < 0.001) allows the prediction success of 92% (sensitivity 73% and specificity 98%). The area under the receiver operating characteristic curve was 94% (95% confidence interval 88-100%, P  < 0.001). Conclusions The presence of visible brain matter, together with a motor score of less than 5, allows accurate identification of non-survivors of cerebral gunshot wounds. Further study is required to validate this score.

Original publication

DOI

10.1308/rcsann.2017.0141

Type

Journal

Annals of the Royal College of Surgeons of England

Publication Date

02/2018

Volume

100

Pages

97 - 100

Addresses

Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal , Durban , South Africa.

Keywords

Humans, Head Injuries, Penetrating, Wounds, Gunshot, Glasgow Coma Scale, Sensitivity and Specificity, Retrospective Studies, ROC Curve, Decision Support Techniques, Adult, Female, Male, Young Adult