Characteristics and Outcomes of Persons with Severe Firearm Related Brain Injuries

Past Studies

Past Studies have focused on death rates and not on outcomes of survivors. Previous studies have indicated that firearms are the most common cause of traumatic brain injury-related deaths in the USA. Death rates for civilian penetrating brain injuries have been high, exceeding 90 percent. Persons at high risk for violent brain injury have been described as men, young adults, unmarried, of a minority race, unemployed, and who had no more than a high school education at the time of injury. Past studies have concluded that socioeconomic factors play a large role in the risk for violent injury.The prognosis for survivors of severe penetrating brain injury generally has been grim. Prognosis has been so poor that researchers have even questioned the use and funding of aggressive medical and surgical management of this population. Research has not assessed functional outcomes following rehabilitation.

This Study

This Study examined 27 persons with severe firearm related brain injuries. They were tracked from hospital admission through discharge from inpatient rehabilitation. Outcome data were collected on the length of stay, Functional Independent Measures scores, and the Disability Rating Scale scores. All participants improved and were discharged to private residential settings. Although some participants required assistance with activities of daily living, all avoided institutional placement.

Who May Be Affected By These Finding

Persons with penetrating brain injuries, service providers, service funders, and advocates.

Caveats

Since most persons with severe penetrating brain injury die within the first 48 hours, initial extended resource use concerns may not be the big issue. This study demonstrated that residential discharge is probable with inpatient rehabilitation. Residential discharge often represents lower future costs and a reduced total burden of care.

Bottom Line

Functional improvement is probable among survivors of severe penetrating brain injury who participate in inpatient rehabilitation. All the participants of this study were able to return to private, residential settings. The authors caution that their findings cannot be generalized to all survivors of penetrating brain injury, because some people die or function at a level too low to participate in inpatient rehabilitation. The authors emphasize that further research needs to be done on survivors of penetrating brain injury. More data concerning costs, community integration, long term medical complications, and the development of assessments that sensitively measure outcomes for this population need to be obtained.

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