THE STUDY JUNE 13, 2011
Americans breathed a sigh of relief on Sunday when Rep. Gabrielle Giffords’ staff released the first photographs of the congresswoman since she was shot during an event in Tucson this January. In the photos, the congresswoman appears smiling and alert, with a scar along her left temple. Giffords was lucky—though she sustained a gunshot wound to the head and the bullet passed through her brain, it did not sever arteries or veins. Additionally, the injury was “through and through,” and the bullet did not hit the midline of the brain. Now her friends say she is speaking in full sentences, though she has more difficulty expressing complex ideas. While her progress has been remarkable so far, Giffords still has a long road of recovery ahead. But in general, what are the odds of surviving a gunshot wound to the head?
Well, at first glance the numbers don't look so good. While victims admitted when the bullet did not penetrate into the brain have a 96 percent survival rate, victims admitted to the hospital with a penetrating injury had a 13 percent survival rate, according to a study from doctors in the trauma surgery department at the Medical University of Vienna. The authors took a retrospective look at 85 patients admitted to Austrian hospitals with head gunshot wounds between 1992 and 2008. Of course, while 13 percent of victims with penetrating wounds survived, the quality of life varied widely, from “persistent vegetative state” to “good recovery.”
The prognosis for Giffords is better, though, than the data would first suggest. The authors found that pupil dilation and Glasgow Coma Scale score at time of hospital admission are the best predictors of outcome. (The Glasgow Coma Scale is a ranking from 3 to 15, with 3 meaning deep coma and 15 meaning fully alert.) Among victims with GCS scores between 9 and 15--almost a quarter of the patients--only one died. Two other Group A patients had “moderate disability” and 17 had “good recoveries.” Though Gifford’s initial GCS hasn’t been released, doctors were optimistic when she was able to follow simple commands upon arriving at the hospital, indicating a high GCS. Let’s hope she continues to progress and she achieves a good recovery.