The effect of the delay between injury and surgery on mortality, morbidity, and complications in craniospinal gunshot wounding

Abstract

Introduction The effect of the surgical approach and the duration between the trauma and surgery on the complications, morbidity, and mortality in cranial and spinal penetrating gunshot injuries are investigated. Methods Evaluation of 63 patients from the Libyan civil war who were referred to the İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital neurosurgery clinic for the treatment and surgery between 2015 and 2017. Results Complications such as meningitis, superficial infection, and abscess developed in 31% of the patients who underwent surgery within the initial 24 h, 58% of the patients who underwent surgery between 24 and 72 h and in all patients who underwent surgery after 72 h. While an improvement was seen in all 14 patients who had preoperative paresis and underwent surgery within 24 h or between 24 and 72 h, only one of the six patients who had paresis and underwent surgery after 72 h improved. One of the patients who underwent surgery within 24 h, three of those who underwent surgery between 24 and 72 h, and four of those who underwent surgery after 72 h died. Conclusion The complications, morbidity, and mortality increase with a prolonged duration between the injury and surgery after craniospinal gunshot wounding.