title: Outcomes and demostration of cranial firearm injuries: A multicenter retrospective study.
abstract: BACKGROUND
  Cranial firearm injuries (CFAI) are associated with significant morbidity and mortality.This study was aimed to determine the factors affecting mortality of CFAI cases managed in our institution by a retrospective analysis of CT scans and clinical data.
  
  
  METHODS
  This multicenter retrospective study examined two hundred and nineteen patients presenting to neurosurgery clinics after CFAI between January 2012 and November 2014. Age, sex, Glasgow Coma Score (GCS), CT findings, and mortality and morbidity rates of the patients were analyzed to determine the factors affecting mortality.
  
  
  RESULTS
  Mean age of the study population was 24.19±12.25 years, 85.8% of them were male. The most common CT findings were fracture (100%), intracranial hemorrhage (61.2%), and an intracranially located foreign body (44.3%). A cranial operation was performed in 64.8% of the victims. Mean GCS on admission was 8±3.9, which increased in survivors (p<0.05).
  
  
  CONCLUSIONS
  CFAIs are associated with increased mortality and morbidity. We determined that many factors affected morbidity and mortality rates, and patient age, presence of intracranial hemorrhage, GCS, and treatment protocols were significantly associated with mortality.
authors.affiliation: Department of Neurosurgery, Şehitkamil State Hospital, Gaziantep, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Çınar
authors.affiliation: Department of Neurosurgery, Deva Hospital, Gaziantep, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Seçer
authors.affiliation: Department of Neurosurgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Alagöz
authors.affiliation: Department of Neurosurgery, Sanko University Konukoglu Hospital, Gaziantep, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ulutaş
authors.affiliation: Department of Neurosurgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Özhan Merzuk
authors.initials: ÖM
authors.lastname: Uçkun
authors.affiliation: Department of Neurosurgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Ali Erdem
authors.initials: AE
authors.lastname: Yıldırım
authors.affiliation: Department of Neurosurgery, Ankara Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Ahmet Gürhan
authors.initials: AG
authors.lastname: Gürçay
authors.affiliation: Department of Neurosurgery, Dr. R.K. Sincan State Hospital, Ankara, Turkey.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Güvenç
authors.affiliation: Department of Neurosurgery, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Haydar
authors.initials: H
authors.lastname: Çelik
authors.affiliation: Department of Neurosurgery, Ankara Memorial Hospital, Ankara, Turkey.
authors.forename: Fırat
authors.initials: F
authors.lastname: Narin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D005260:Female; D015600:Glasgow Coma Scale; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D020198:Intracranial Hemorrhage, Traumatic / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D014421:Turkey; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D055815:Young Adult