AI Article Synopsis
Article Abstract
Background: Treatment of gunshot wounds of the brain (GSWB) remains controversial and there is high variation in reported survival rates (from < 10 to > 90%) depending on the etiology and country. We retrospectively analyzed the outcome of a series of consecutive GSWB patients admitted alive to a level 1 trauma center in a safe high-income welfare country with a low rate of homicidal gun violence.
Methods: Patients admitted due to a GSWB to the HUS Helsinki University Hospital during 2000-2012 were identified from hospital discharge registry and log books of the emergency room and ICU. CT scans and medical records of these patients were reviewed. Univariate analysis and backward logistic regression were performed, and their results compared with that of a systematic literature review of factors related to the outcome of GSWB patients.
Results: Sixty-four patients admitted alive after GSWB were identified. Eighty percent had self-inflicted GSWB, 81% were contact shots, and 70% were caused by handguns. In-hospital mortality was 72%. Factors associated with mortality in our series were low GCS (≤ 8) at admission, transventricular bullet trajectory, and associated damage to deep brain structures, as reported before in the literature. Of the 64 patients admitted alive, 42% (27/64) were admitted to ICU, 34% (22/64) underwent surgery, and in 25% (16/64), craniotomy and hematoma evacuation was performed. Mortality in the surgically treated group was 32% but near 100% without surgery and ICU treatment. Median GOS in the surgically treated patients was 3 (range 1-5).
Conclusions: GSWB caused by contact shot from handguns has a high mortality rate, but can be survived with reasonable outcome if limited to lobar injury without significant damage to deep brain structures or brain stem. In such GSWB patients, initial aggressive resuscitation, ICU admission, and surgery seem indicated.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6581925 | PMC |
| http://dx.doi.org/10.1007/s00701-019-03952-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[A Case of Pathological Complete Response after Nivolumab Therapy in Unresectable Advanced Gastric Cancer].
Gan To Kagaku Ryoho
December 2024
Dept. of Surgery, Nara Prefecture General Medical Center.
A 70-year-old man was admitted to a local hospital with epigastric pain and diagnosed with type-2 gastric cancer. Contrast-enhanced CT scan showed metastases in S3 and S8 of the liver, and the tumor was classified as type cT4aN2H1, cStage ⅣB. Nivolumab monotherapy was initiated after failure of treatment with S-1 plus oxaliplatin and ramucirumab.
View Article and Find Full Text PDFDiffuse Large B-cell Lymphoma with a Multilobated Nuclear Morphology Harboring t (14;18) (q32;q21) and t (3;22) (q27;q11): A Case Report.
Intern Med
December 2024
Department of Hematology, Osaka General Hospital of West Japan Railway Company, Japan.
A 70-year-old woman was admitted to our hospital with dyspnea. Atypical cells with multilobated nuclei were observed in the pleural effusion. Diffuse large B-cell lymphoma (DLBCL) was diagnosed based on a cell block analysis.
View Article and Find Full Text PDFOutcomes of Acute Subdural Hematoma in Adults with a GCS Score of 3 : An Analysis from Five Regional Trauma Centers.
J Korean Neurosurg Soc
December 2024
Korea Neuro-Trauma Data Bank Committee, Korean Neurotraumatology Society, Korea.
Objective: Acute Subdural Hematoma (A-SDH) in patients with a Glasgow Coma Scale (GCS) score of 3 presents significant challenges in clinical decision-making owing to high mortality rates and the likelihood of severe disability. Here, we analyzed data to assess the number of surgical treatments and overall treatment outcomes for patients with A-SDH admitted in a comatose state and discussed the value of such aggressive surgical interventions based on these findings.
Methods: A retrospective analysis was conducted using data from five regional trauma centers in Korea registered with the Korean Neurotrauma Data Bank System.
Implicit bias in the patient descriptor "homeless" and its association with emergency department opioid administration and disposition.
Am J Emerg Med
December 2024
Department of Medicine, California Pacific Medical Center, San Francisco, CA, USA. Electronic address:
Background: Biased language in provider documentation of marginalized patient populations has been shown to negatively influence patient management. There has been debate over the use of "homeless" as a descriptor of people experiencing homelessness (PEH), as it is a potentially biased term with negative connotations. This study explores the relationship between the use of the word "homeless" in Emergency Department (ED) provider documentation and admission rates, as well as intravenous (IV) vs.
View Article and Find Full Text PDFEthnicity does not change burn resuscitation and time to first excision.
Burns
December 2024
Parkland Health, 5200 Harry Hines Blvd, Dallas, TX 75235, USA. Electronic address:
Health and racial disparities can limit access to preventative, trauma, and chronic disease care but have not been addressed in burn resuscitation. Over- and under-resuscitation contribute to increased overall hospital costs, and morbidity and mortality rates. The primary objective of this study was to identify potential racial disparities that may exist during the initial fluid resuscitation after burn injury.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!