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Erschienen in:
12.09.2017 | Original Article
Validation of the Baragwanath mortality prediction score for cerebral gunshot wounds: the Pietermaritzburg experience
Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2018
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Introduction
Cerebral gunshot wounds (GSW) are highly lethal injuries. To date, only one clinical scoring system to predict mortality in a developing world setting has been described. This is the Baragwanath mortality prediction score (“ABC”: admission blood pressure, brain matter spillage and consciousness level).
Materials and methods
We performed a retrospective review of prospectively entered data for a cohort of patients with isolated cerebral GSWs over a 5-year period (January 2010–December 2014) in our institution. We aimed to validate the Baragwanath ABC mortality prediction score in our population.
Results
During the 5-year study period, 102 patients with isolated cerebral GSWs were reviewed, 22% (22/102) of which died. Based on the total ABC score (1–5), the mortality was 0% for 1, 21% for 2, 67% for 3, 92% for 4, and 100% for 5. The ABC score has a sensitivity of 82% (95% CI 60–95%), specificity of 96% (95% CI 89–99%), PPV of 86% (95% CI 66–96%) and NPV of 95% (95% CI 86–99%).
Conclusions
The Baragwanath mortality prediction score accurately predicts non survival of patients with a cerebral GSW in our patient cohort. Further validation studies in other populations are required before this system can be widely adopted.