Factors that influenced infection complications in combat related penetrating brain injuries during conflict in Ukraine

Abstract

"Infection complication has a major impact on outcomes of patients with combat related penetrating head injuries. There is still a discussion around which factor influence outcomes and infection complication. In the beginning of war, in 2014, the evacuation system was not ready for a sudden start of hostilities because of limited medical resources, the lack of neuro visualization in the frontline, the lack of trained personnel provided first aid to the wounded. Aim: The aim of this study is to determine the factors that influenced the development of infectious complications in penetrating combat head injuries with limited medical capabilities on theatre Materials and methods: This is retrospective study of 79 military cases with penetrating head injuries, which was received during the fighting in eastern Ukraine in the period from March 2014 to the end of December 2017. Information was collected on demographics, evacuation assistance, type of injury and infectious complications. R commander was used for statistical analysis. Statistical significance was defined as p<0.05. Results: Infection complication of CNS were detected in 31 cases (39,24%). Factors that influence rate of infection are low GCS on first evaluation (p<0.001), CSF leak (p=0.002), ventricular injury (p<0.005), installation of tidal drainage (p=0.005), superficial wound infection (p=0.013) and wound dehiscence (p<0.001). Conclusions: There are many controversies in managing penetrating gunshot wounds to the head. Still exist lack of information that neurosurgeon can trust. Data even about small samples still very informative "