PT  - JOURNAL ARTICLE
AU  - Leigh Anna Robinson
AU  - Lauren M Turco
AU  - Bryce Robinson
AU  - Joshua G Corsa
AU  - Michael Mount
AU  - Amy V Hamrick
AU  - John Berne
AU  - Dalier R Mederos
AU  - Allison G McNickle
AU  - Paul J Chestovich
AU  - Jason Weinberger
AU  - Areg Grigorian
AU  - Jeffry Nahmias
AU  - Jane K Lee
AU  - Kevin L Chow
AU  - Erik J Olson
AU  - Jose L Pascual
AU  - Rachele Solomon
AU  - Danielle A Pigneri
AU  - Husayn A Ladhani
AU  - Joanne Fraifogl
AU  - Jeffrey Claridge
AU  - Terry Curry
AU  - Todd W Costantini
AU  - Manasnun Kongwibulwut
AU  - Haytham Kaafarani
AU  - Janika San Roman
AU  - Craig Schreiber
AU  - Anna Goldenberg-Sandau
AU  - Parker Hu
AU  - Patrick Bosarge
AU  - Rindi Uhlich
AU  - Nicole Lunardi
AU  - Farooq Usmani
AU  - Joseph Victor Sakran
AU  - Jessica M Babcock
AU  - Juan Carlos Quispe
AU  - Lawrence Lottenberg
AU  - Donna Cabral
AU  - Grace Chang
AU  - Jhoanna Gulmatico
AU  - Jonathan J Parks
AU  - Rishi Rattan
AU  - Jennifer Massetti
AU  - Onaona Gurney
AU  - Brandon Bruns
AU  - Alison A Smith
AU  - Chrissy Guidry
AU  - Matthew E Kutcher
AU  - Melissa S Logan
AU  - Michelle Y Kincaid
AU  - Chance Spalding
AU  - Matthew Noorbaksh
AU  - Frances H Philp
AU  - Benjamin Cragun
AU  - Robert D Winfield
TI  - Outcomes in patients with gunshot wounds to the brain
AID  - 10.1136/tsaco-2019-000351
DP  - 2019 Nov 01
TA  - Trauma Surgery & Acute Care Open
PG  - e000351
VI  - 4
IP  - 1
4099  - http://tsaco.bmj.com/content/4/1/e000351.short
4100  - http://tsaco.bmj.com/content/4/1/e000351.full
SO  - Trauma Surg Acute Care Open2019 Nov 01; 4
AB  - Introduction Gunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR.Methods We performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at a referring hospital, in the field, or in the trauma resuscitation room. Patients were excluded for significant torso or extremity injuries, or if pregnant. Binomial regression models were used to determine predictors of survival/organ donation.Results 825 patients met study criteria; the majority were male (87.6%) with a mean age of 36.5 years. Most (67%) underwent CPR in the field and 2.1% (n=17) survived to discharge. Of the non-survivors, 17.5% (n=141) were considered eligible donors, with a donation rate of 58.9% (n=83) in this group. Regression models found several predictors of survival. Hormone replacement was predictive of both survival and organ donation.Conclusion We found that GSWB requiring CPR during trauma resuscitation was associated with a 2.1% survival rate and overall organ donation rate of 10.3%. Several factors appear to be favorably associated with survival, although predictions are uncertain due to the low number of survivors in this patient population. Hormone replacement was predictive of both survival and organ donation. These results are a starting point for determining appropriate treatment algorithms for this devastating clinical condition.Level of evidence Level II.