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University of Massachusetts neurologists develops new tool to predict survival after penetrating brain injury

A new study published October 26, 2016 in the online issue of Neurology describes a new tool for predicting a person’s survival after a penetrating brain injury, such as a gunshot wound. The tool, SPIN-Score, which stands for Surviving Penetrating Injury to the Brain, is the first-of-its kind and will hopefully help family members and patients make crucial decisions about the course of care after a penetrating brain injury.

In the study, researchers analyzed 10 years of data from a level-one trauma center in Maryland and another in Massachusetts. The study looked at data from 413 penetrating brain injury patients, most of whom suffered from gunshot wounds. 87% of those in the study were men, 56% were African American, and the average age was 33 years. The researchers looked to see which factors were associated with the patients surviving the injury in the hospital, as well as 6 months later.

"Gunshot wounds are the number one cause of penetrating traumatic brain injuries," said study author Susanne Muehlschlegel, MD, MPH, of the University of Massachusetts Medical School in Worcester, Mass., and member of the American Academy of Neurology. "Much of our knowledge about surviving such injuries comes from the battlefield, not from shootings among civilians. Being better able to determine the average person's chance of survival could help doctors and families make important decisions about medical treatment."

The two most important factors found were pupil dilation in response to light and movement in response to stimuli, such as moving on command or having a reflex reaction to pain. Other factors associated with survival were also found, but their contribution to the test’s accuracy was nominal compared to the strength delivered by the main two. With the SPIN-Score, a 96% accuracy of whether people would survive or not was achieved.

"More research is needed to validate the SPIN-Score, so for now, it remains a preliminary prediction tool," Muehlschlegel said. "Still, developing this tool is an important step toward improving overall outcomes."

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