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Study finds gunshot wounds to the head not 'a death sentence'

In Baltimore, one of every three people struck by gunfire dies. That means it ranks as the most lethal of America’s largest cities, according to a Baltimore Sun analysis. (Baltimore Sun video)

Victims of gunshot wounds to the head who make it to the hospital alive have a 42 percent chance of surviving, according to new research based largely on hundreds of patients treated at the University of Maryland Shock Trauma Center.

The finding, which also included patients from the University of Massachusetts Memorial Medical Center, was somewhat surprising even to the study authors who have long worked in trauma care and were looking for clues about who was most likely to survive such traumatic head wounds.

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"I think it is a surprisingly good number," said a study author Dr. Deborah M. Stein, a professor of surgery at the Maryland's School of Medicine and chief of trauma at the Shock Trauma Center. "Still, 58 percent are dying and that's way too many. As good as the care, in 2016, the only way to prevent that is to not get shot."

The researchers undertook the study to support what many trauma doctors believed was true about who survives the grievous injuries and who does not, she said. The study found those who are most alert upon arrival, whose pupils react most to light, and whose bodies are the least traumatized tend to have the best chances.

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They also found that those shot only once in the head have an 87 percent greater chance of survival than those shot multiple times. A spray of bullets is just much more likely to hit important parts of the brain, she said.

The findings come on the heels of a Baltimore Sun investigation that found victims in the city are more likely to be shot multiple times and shot in the head, as criminals increasingly use higher-caliber guns with large magazine and more damaging bullets.

The investigation also found that one person is killed for every three shot in Baltimore, making the city deadlier than a decade ago and one of the nation's most lethal.

Emergency rooms are seeing twice the number of gunshot cases as five years ago, and improvements in care have not always kept pace.

Stein said she didn't "want to understate the lethality of this injury."

Many victims never make it to the hospital, she acknowledged, and they were not counted in the Maryland study. Still, the study will help doctors make better prognosis about gunshot victims.

Stein also said Shock Trauma's patients fared a bit worse than those included in the study from the University of Massachusetts in less urban Worcester, Mass. But that's because they come to Shock Trauma in worse shape and get to the hospital faster, only to die once inside.

But Stein also said she hopes hospitals around the country read the study and understand a gunshot wound to the head "is not necessarily a death sentence.

"I think a key message is we should never be giving up or saying there is nothing we can do."

Stein produced the research, published in journal Neurology, along with Dr. Thomas M. Scalea, a Maryland professor of trauma surgery and physician-in-chief at the trauma center, as well as trauma researchers from the University of Massachusetts, Harvard and Yale.

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