20. Factors Predicting Poor Outcome in Gunshot Injuries to Brain
Muhammad Yousuf Shaikh, Muhammad Aamir Saghir, Salman Sharif and Samir Irfan
ABSTRACT
Objective: In view of the recent rise in the incidence of gunshot injuries, it is quite mandatory for scientific studies evaluating the prognostic factors contributing to the outcome of such patients. This study aims to identify such factors and evaluate them clinically
Study Design: Retrospective study
Place and Duration of Study: This study was conducted at the Department of Neurosurgery, Liaquat National Hospital & Medical College, Karachi from July 2012 to July 2017.
Materials and Methods: All patients that suffered gunshot injury from July 2012 to July 2017 were included in the study. Exclusion criteria included all patients that were brought dead or expired within two hours of surgery. Duration of stay, CT scan findings and GOS (Glasgow outcome score) were used to evaluate the prognosis of the patients. The prognostic factors evaluated in the study included age, sex, time of presentation and GCS on presentation.
Results: This study included a total sample size of 45 patients after inclusion and exclusion based on established criteria. The average age of the patients was 32 years. About 15% of them were female while 85 % were male. Majority of the patients presented more than 24 hours after the incident (71%). Overall mortality was 6 %( 3 patients). On further analysis, higher GCS was associated with a better outcome (<0.05). Our study also showed that extensive brain injury was associated with a poor outcome with a statistically significant difference (<0.05)
Conclusion: Gunshot injuries to brain represent a high mortality and neurosurgical emergency. Admitting GCS and number of lobes involved were identified to be the most important predictors of poor outcome but if managed aggressively will have favorable outcomes.
Key Words: Firearm, head injuries, multilobar, Glasgow Outcome Scale
Citation of articles: Shaikh MY, Saghir MA, Sharif S, Irfan S. Factors Predicting Poor Outcome in Gunshot Injuries to Brain. Med Forum 2018;29(9):80-83.