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.