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Journal Article

Citation

Kong VY, Odendaal J, Sartorius B, Clarke DL, Bruce JL, Laing GL, Esterhuizen T. Ann. R. Coll. Surg. Engl. 2018; 100(2): 97-100.

Affiliation

Centre for Evidence Based Health Care, Department of Global Health, University of Stellenbosch , Stellenbosch , South Africa.

Copyright

(Copyright © 2018, Royal College of Surgeons of England)

DOI

10.1308/rcsann.2017.0141

PMID

29022788

Abstract

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.


Language: en

Keywords

Cerebral; Gunshot wound; Mortality

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