Prediction of Outcome in Patients with Missile Craniocerebral Injuries during the Croatian War

Abstract

The factors assumed to exert an influence on the outcomes of 176 patients who sustained head injuries through projectiles during the Croatian War were evaluated. The type of projectile, wound age, retained foreign bodies, and patient sex and age had no significant influence on outcome. Patients with a Glasgow Coma Scale score of 3 to 5 had 7.3 times higher relative risk of poor outcome than those with a score of 6 to 15. Patients with penetrating injuries (47%), with a projectile's path traversing both hemispheres (45.5%), and with intracranial hematomas (49%) had significantly poorer outcomes than patients without such lesions. Infections were more common in patients with retained foreign bodies in wounds that were older than 48 hours (43%) and in patients with cerebrospinal fluid fistulas (50%). In assessing the outcomes of missile head injuries in wartime, the Glasgow Coma Scale score, type of head wound, site of skull penetration, endocranial projectile path, intracranial hematomas, and complications, especially infectious, represent reliable predictors of outcome.