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Gunshot wounds to the brain are usually fatal, with reported survival rates of 7% to 15%. In 2008, a trauma center in Arizona instituted a new aggressive resuscitation policy that involved treating all patients with gunshot wounds to the brain with one or more of blood products (1:1 red blood cells to fresh frozen plasma), hyperosmolar therapy, and vasopressors, prothrombin complex concentrate, or both, to correct coagulopathy. To determine if survival rates improved, researchers retrospectively reviewed 132 records for 132 patients between 2007 and 2011.
The overall survival rate was 30%, with rates increasing yearly from 10% in 2008 to 46% in 2011. Survivors had higher initial systolic blood pressures (mean, 110 vs. 79 mm Hg), higher Glasg…