Table 2.
Clinical presentation and outcome. Patients are stratified according to their level of consciousness on admission into those with Glasgow Coma Scale (GCS) > 8 or ≤ 8, since GCS ≤ 8 signifies a decreased level of consciousness indicating intubation and mechanical ventilation to secure the airway and ensure sufficient ventilation, especially in patients with brain trauma. Intubation and mechanical ventilation require sedation, and in our series, 13 patients were intubated in the field before admission. For the remaining 51 patients, GCS score on admission could be determined for 48 patients. Of note is the observation that although subdural (SDH) or parenchymal hemorrhage (ICH) was observed in most patients, in most of them, the hematoma was not large enough to cause significant expansive effect indicated by midline shift (presence of midline shift indicates a > 1-mm midline shift). This was observed also in GCS ≤ 8 patients, and thus it can be concluded that although present in most patients, intracranial hematoma is usually not the cause of decreased level of consciousness in GSWB patients. In the GCS ≤ 8 patients in whom midline shift was present to measurable extent (n = 10), median shift was 9 mm (range 3–16 mm). Due to the retrospective nature of our study, we were not able to determine all the study variables accurately for all the patients. Because of this, the results are reported so that both the number of index cases and the number of patients from whom we were able to gather the information are given
| Variable | Status at hospital admission | p value | |
|---|---|---|---|
| GCS > 8 | GCS ≤ 8 | ||
| Documented on-site loss of consciousness | 0.0% (0/9) | 94.9% (37/39) | < 0.001 |
| GCS on site: median (min–max) | 15 (12–15), n = 9 | 3 (3–10), n = 39 | < 0.001 |
| GCS on admission: median (min–max) | 15 (11–15), n = 9 | 3 (3–7), n = 39 | < 0.001 |
| Thoracoabdominal injuries | 0% (0/9) | 2.6% (1/39) | < 0.001 |
| Hypotension (during transport) | 14.3% (1/7) | 35.5% (11/31) | 0.395 |
| Edema | 33.3% (3/9) | 93.8% (30/32) | < 0.001 |
| Presence of any midline shift | 33.3% (3/9) | 40.6% (13/32) | 1.000 |
| SDH | 55.6% (5/9) | 68.8% (22/32) | 0.692 |
| ICH | 55.6% (5/9) | 87.5% (28/32) | 0.054 |
| Wound tract through the ventricles in CT | 0.0% (0/9) | 61.5% (24/39) | < 0.001 |
| Wound tract through the basal ganglia in CT | 22.2% (2/9) | 71.9% (23/32) | 0.023 |
| Wound tract through the thalamus in CT | 0.0% (0/9) | 43.8% (14/32) | 0.049 |
| Wound tract in CT through the brain stem/medulla oblongata | 0.0% (0/5) | 23.1% (3/13) | 0.383 |
| Surgical intervention | 77.8% (7/9) | 20.5% (8/39) | 0.002 |
| GOS: median (min–max) | 5 (3–5), n = 6 | 1 (1–5), n = 38 | < 0.001 |
| Death | 0,0% (0/9) | 92.3% (36/38) | < 0.001 |