Prognostic factors of intracranial purulent-septic complications of combat-related gunshot penetrating skull and brain wounds.

Authors

  • A. G. Sirko
  • L. A. Dzyak
  • G. S. Pylypenko
  • I. O. Yovenko
  • A. A. Skrypnik

DOI:

https://doi.org/10.26641/2307-0404.2019.3.181881

Keywords:

purulent-septic complications, intracranial complications, craniocerebral wounds, combat-related gunshot wounds, prognostic factors, antibacterial therapy, mortality, outcomes

Abstract

Purpose – to ana­lyze the structure of intracranial purulent-septic complications (IPSC), determine the factors influencing development of purulent-septic complications in patients with combat-related gunshot penetrating skull and brain wounds (CRPSBW), determine the effect of intracranial PSC on patients’ outcomes. A prospective analysis of results of exa­mination and treatment of 121 patients was performed. All patients had gunshot penetrating skull and brain wounds sustained in combat conditions during a local armed conflict in the Eastern Ukraine. Evaluation of treatment outcome included analysis of mortality in 1 month (survived/died) and dichotomous Glasgow Outcome Scale (GOS) score in 12 months (favorable/unfavorable outcome). 121 wounded men aged 18 to 56 (average, 34.1±9.1) were included in the study. Intracranial purulent-septic complications (IPSC) were diagnosed in 14 (11.6%) gunshot CRPSBW patients. The following prognostic factors had statistically significantly correlation with the risk of intracranial purulent-septic complications development: wound liquorrhea on admission (p = 0.043), intraventricular hemorrhage (p = 0.007), bone fragments left in the wound (p = 0.0152), and  duration of inflow-outflow wound drainage for more than 3 days (p= 0.0123). Intracranial PSC patients had mortality rate of 50%, and only 14.3% of those patients had a favorable outcome according to GOS score in one year. Presence of intracranial PSC had statistically significant association with mortality rate (p=0.0091) and GOS score in one year (p=0.0001).

Author Biographies

A. G. Sirko

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» 1
Department of Nervous Diseases and Neurosurgery FPE
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

L. A. Dzyak

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» 1
Department of Nervous Diseases and Neurosurgery FPE
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

G. S. Pylypenko

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» 1
Department of Nervous Diseases and Neurosurgery FPE
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

I. O. Yovenko

ME «Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov» 2
Soborna sq., 14, Dnipro, 49005, Ukraine

A. A. Skrypnik

SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» 1
Department of Nervous Diseases and Neurosurgery FPE
V. Vernadsky str., 9, Dnipro, 49044, Ukraine

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How to Cite

1.
Sirko AG, Dzyak LA, Pylypenko GS, Yovenko IO, Skrypnik AA. Prognostic factors of intracranial purulent-septic complications of combat-related gunshot penetrating skull and brain wounds. Med. perspekt. [Internet]. 2019Nov.5 [cited 2024Nov.7];24(3):58-66. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/181881

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CLINICAL MEDICINE