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Pediatric Intracranial Gunshot Wounds: Lessons From the Newark Experience.

Antonia M Sames1, Arman Sawhney1, Tannishtha Som1

  • 1Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.

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Summary
This summary is machine-generated.

Pediatric gunshot wounds to the head have a high mortality rate. Survivors show better Glasgow Coma Scale scores and lower lab values on admission, but current scoring systems poorly predict outcomes.

Keywords:
Firearm injuryPediatric emergency carePediatric neurocritical carePediatric traumaPediatric traumatic brain injury

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Area of Science:

  • Pediatric Traumatology
  • Neurosurgery
  • Medical Imaging Analysis

Background:

  • Pediatric gunshot wounds to the head (GSWH) are critical injuries with high mortality (20-65%).
  • Existing prognostic tools like the St. Louis Score (SLS) and Rotterdam CT Score lack specific validation in pediatric GSWH.
  • Limited data exists on predictive factors for mortality and functional outcomes in this vulnerable population.

Purpose of the Study:

  • To identify key factors predicting mortality and functional outcomes in pediatric GSWH.
  • To evaluate the predictive accuracy of the St. Louis Score (SLS) and Rotterdam CT Score in pediatric GSWH.

Main Methods:

  • Retrospective review of 14 pediatric patients (≤18 years) with GSWH.
  • Analysis of demographics, injury characteristics, imaging findings, and outcomes.
  • Receiver operator curve analysis for prognostic tools; comparison between survivors/nonsurvivors and favorable/unfavorable outcomes.

Main Results:

  • Overall mortality rate was 65%.
  • Survivors had higher Glasgow Coma Scale (GCS), lower international normalized ratio (INR), lower serum glucose, and lower Rotterdam CT Scores.
  • Both SLS and Rotterdam CT Score showed poor predictive accuracy for mortality.

Conclusions:

  • Survivors of pediatric GSWH present with distinct admission profiles (higher GCS, lower INR, lower glucose).
  • The Rotterdam CT Score showed slightly better performance than SLS but both were suboptimal predictors.
  • Further research with larger cohorts is essential to develop improved prognostic models for pediatric GSWH.