PT - JOURNAL ARTICLE AU - Robinson, Leigh Anna AU - Turco, Lauren M AU - Robinson, Bryce AU - Corsa, Joshua G AU - Mount, Michael AU - Hamrick, Amy V AU - Berne, John AU - Mederos, Dalier R AU - McNickle, Allison G AU - Chestovich, Paul J AU - Weinberger, Jason AU - Grigorian, Areg AU - Nahmias, Jeffry AU - Lee, Jane K AU - Chow, Kevin L AU - Olson, Erik J AU - Pascual, Jose L AU - Solomon, Rachele AU - Pigneri, Danielle A AU - Ladhani, Husayn A AU - Fraifogl, Joanne AU - Claridge, Jeffrey AU - Curry, Terry AU - Costantini, Todd W AU - Kongwibulwut, Manasnun AU - Kaafarani, Haytham AU - San Roman, Janika AU - Schreiber, Craig AU - Goldenberg-Sandau, Anna AU - Hu, Parker AU - Bosarge, Patrick AU - Uhlich, Rindi AU - Lunardi, Nicole AU - Usmani, Farooq AU - Sakran, Joseph Victor AU - Babcock, Jessica M AU - Quispe, Juan Carlos AU - Lottenberg, Lawrence AU - Cabral, Donna AU - Chang, Grace AU - Gulmatico, Jhoanna AU - Parks, Jonathan J AU - Rattan, Rishi AU - Massetti, Jennifer AU - Gurney, Onaona AU - Bruns, Brandon AU - Smith, Alison A AU - Guidry, Chrissy AU - Kutcher, Matthew E AU - Logan, Melissa S AU - Kincaid, Michelle Y AU - Spalding, Chance AU - Noorbaksh, Matthew AU - Philp, Frances H AU - Cragun, Benjamin AU - Winfield, Robert D 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.