Introduction: The evaluation was carried on patients who were injured in the Syrian war and treated in our clinic, between March 2012 and March 2015.
The physiopathology of the injuries, injury patterns and types were investigated. Age, gender, Glasgow Coma Score (GCS), CT images, mortality-morbidity rates and treatment strategies were evaluated to.
Methods: 329 patients were evaluated, 80% were adults. The age of victims ranged from 2 months to 81 years. In terms of injury types, 196 patients (59.5%) had shell fragment injuries, 71 (21.5%) had bullet injuries and 62 (%18.8) had suffered from bomb or other explosives. In terms of injury patterns, 149 (45.2%) showed penetrating injuries, 126 (38.2%)had blunt injuries, 33 (10%) had tangential injuries, 21 (6.3%) had perforating injuries. According to admission GCS of the patients, GCS was 3 (group-1) in 62 patients (18.8%), between 4-7 (group-2) in 111 patients (33.7%), and between 8-15 (group-3) in 156 patients (47.4%).
135/329 patients (41.03%) died.
In regard to distribution of the patients who died, in surgical treatment approach, all the 7 patients in group-1, 28/61 patients in group-2 (45.9%) and 2/44 patients in group-3 (%5) died. In the conservative treatment approach, all the 55 patients in group-1, 38/50 patients in group-2 (76%), and 5/112 patients in group-3 (4.4%) died.
Results: There is obviously difference between the mortality rate in the surgical approach and the mortality rate of the conservative approach for group-2. In the other groups, there are no significant differences in mortality rate between surgical and conservative approach.
Conclusions: Our experience; GCS score are important factor for survival and the time of arrival has great importance on mortality. Despite the diversity of views in the literature, patients with GCS of 4 and above should be operated. The mortality rate is decreases in the surgical approach for who had GCS score between 4-7.
Patient Care: it can reduce the mortality rate in cranial gunshot wounds
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of surgical appraoch in who had GCS between 4-7