Characterization of 95 patients with traumatic brain injury due to gunshot wounds at a referral center in Cali, Colombia

Abstract

Objective: This study aims to describe cases of traumatic brain injury due to gunshot wounds in civilian population over 18 years of age, treated at a referral hospital in Cali, Colombia and compare the clinical outcomes at discharge.

Methods: An observational, descriptive cross-sectional study was conducted by retrospectively collecting clinical data related to adult patients that presented traumatic brain injury due to civil gunshot-wounds and that consulted to the emergency room at Fundación Valle del Lili Hospital in Cali, Colombia between January 2010 and February of 2016. A univariate analysis was performed to determine factors associated with death and adverse clinical outcomes.

Results: A total of 95 patients older than 18 years, with traumatic brain injury by gunshot were included in the civil context. The 91.6% were male. The main context was interpersonal violence with 54.7%. The most common method of transportation was by ambulance (79%). The Glasgow score at admission was 3-8 in 64.2% of cases; 9-12 in 6.32% and 13-15 in 28.4%. On admission, head CT scan was performed in 82 (86.3%) patients within the first hour, finding a Marshall-Score between I-III in 60.9%, of IV in 17.8% of cases and a score between V-VI and in 4.1%. The trajectory was non-transfixing penetrating in 43.2%, transfixing in 27.3% and tangential in 9.5%. Mortality was 45.3% in total, 39% died within the first 24hours.

Conclusions: A major compromise on admission determines an overall poorer prognosis and a high likelihood of death in the first 24-hours.

Keywords: Adult; Adultos; Gunshot; Herida por proyectil de arma de fuego; Penetrating brain injury; Trauma craneano penetrante; Trauma craneoencefálico; Traumatic brain injury.