Ateþli silahla baþýndan yaralanmýþ sivil hastalarda prognozu etkileyen faktörlerin ayrýmý için istatistiksel bir çalýþma

A statistical analysis for the identification of factors effecting prognosis of civilian patients with cranial gunshot wounds

BACKGROUND: Patients with civil cranial gunshot injuries who were treated in our hospital were statistically analized for the factors acting on 7 days survival and prognosis without regarding treatment modalities. MATERIAL AND METHOD: Patients were divided into two groups according to the mortality rates in 7 days following the trauma without regarding treatment modalities. Initial GCS score, pupillary response to light, coagulopathy, ventricular penetration and number of hemispheres affected are 5 differentials evaluated separately and in combination for their effects on mortality rates within 7 days posttraumatically and their statistical significance. RESULTS: Thirty six male (75%) and 12 female (25%) patients included in the study. Total and 7 day- survival rates were 27% (13/48), and 31% (15/48) respectively. Among GCS scores, pupillary defects, coagulopathy, intraventricular penetration, the number of hemispheres affected, the most important prognostic factors of the patients living less than 7 days were found to be primarily coagulopathy and then pupillary defects. The other variables were not significantly effective and the results were in accordance with the literature. CONCLUSION: In civilian patients with cranial gunshot injuries pupillary defect and coagulopathy were statistically significant prognostic factors. We think that agressive medical and surgical treatment will be beneficial even if the patients’ neurological status is deteriorating.