Neurobehavioural outcomes of penetrating and tangential gunshot wounds to the head

Abstract

Objective: The objective of this study was to compare penetrating and tangential gunshot wounds to the head with regards to demographic, neurobehavioural and clinical outcome measures.

Methods: Twenty-nine patients with penetrating gunshot wounds (P-GSW) and 11 patients with tangential gunshot wound (T-GSW) to the head admitted to an acute neurotrauma service were compared using standardized neurobehavioural and clinical outcome measures.

Results: The mean GCS was 10.5 +/- 0.79 for the P-GSW group and 13.4 +/- 0.72 for the T-GSW group. The mean AIS-CNS for the P-GSW group was 5.00 +/- 0 and for the T-GSW group was 3.7 +/- 0.27. Significance was found on Digit Span (p < 0.05) and Block Design (p < 0.009) subtests. Outcomes between the two groups were similar, except for significant differences were found for acute length of stay (LOS) (P-GSW was 47.72 +/- 13.2 and T-GSW group was 13.0 +/- 1.3, p = 0.005) and for acute care charges (P-GSW group was $150,533 +/- 23,834 and T-GSW group was $70,712 +/- 16,587, p = 0.05).

Conclusions: Initially, a penetrating gunshot wound is a more severe and costly injury than a tangential gunshot wound to the head, however T-GSW possess significant deficits and, if the patient survives past the acute phase of recovery, the two groups have similar functional outcomes. Future standard classification, neuropsychological, and clinical outcome measures.