RT Journal Article SR Electronic T1 Outcomes in patients with gunshot wounds to the brain JF Trauma Surgery & Acute Care Open JO Trauma Surg Acute Care Open FD BMJ Publishing Group Ltd SP e000351 DO 10.1136/tsaco-2019-000351 VO 4 IS 1 A1 Robinson, Leigh Anna A1 Turco, Lauren M A1 Robinson, Bryce A1 Corsa, Joshua G A1 Mount, Michael A1 Hamrick, Amy V A1 Berne, John A1 Mederos, Dalier R A1 McNickle, Allison G A1 Chestovich, Paul J A1 Weinberger, Jason A1 Grigorian, Areg A1 Nahmias, Jeffry A1 Lee, Jane K A1 Chow, Kevin L A1 Olson, Erik J A1 Pascual, Jose L A1 Solomon, Rachele A1 Pigneri, Danielle A A1 Ladhani, Husayn A A1 Fraifogl, Joanne A1 Claridge, Jeffrey A1 Curry, Terry A1 Costantini, Todd W A1 Kongwibulwut, Manasnun A1 Kaafarani, Haytham A1 San Roman, Janika A1 Schreiber, Craig A1 Goldenberg-Sandau, Anna A1 Hu, Parker A1 Bosarge, Patrick A1 Uhlich, Rindi A1 Lunardi, Nicole A1 Usmani, Farooq A1 Sakran, Joseph Victor A1 Babcock, Jessica M A1 Quispe, Juan Carlos A1 Lottenberg, Lawrence A1 Cabral, Donna A1 Chang, Grace A1 Gulmatico, Jhoanna A1 Parks, Jonathan J A1 Rattan, Rishi A1 Massetti, Jennifer A1 Gurney, Onaona A1 Bruns, Brandon A1 Smith, Alison A A1 Guidry, Chrissy A1 Kutcher, Matthew E A1 Logan, Melissa S A1 Kincaid, Michelle Y A1 Spalding, Chance A1 Noorbaksh, Matthew A1 Philp, Frances H A1 Cragun, Benjamin A1 Winfield, Robert D YR 2019 UL http://tsaco.bmj.com/content/4/1/e000351.abstract 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.