Major cardiothoracic trauma: Eleven-year review of outcomes in the North West of England

Abstract

INTRODUCTION Up to 15% of patients with cardiothoracic trauma require emergency surgery, and death can be prevented in a substantial proportion of this group. UK reports have emphasised the need for improvement in this field. We assessed major cardiothoracic trauma (MCT) outcomes in North West England over 11 years. METHODS The database from the Trauma Audit and Research Network was used to retrieve data for all patients who had suffered MCT between 2000 and 2011 in North West England and the findings analysed. Trauma that led to thoracotomy/thoracoscopy or sternotomy was defined as MCT. RESULTS A total of 146 patients were identified, and a considerable male predominance (88.4%) noted. A total of 54.1% had sustained penetrating cardiothoracic trauma. Also, 53.4% had been admitted to tertiary-care hospitals for trauma (TCHT) and 46.6% had been admitted to non-TCHT. Overall prevalence of mortality was 35.6%. No significant difference was found in mortality between TCHT vs non-TCHT. Prevalence of mortality was significantly higher in the subgroup of patients cared for exclusively in non-TCHT compared with patients transferred from non-TCHT to TCHT (41% vs 13.8%, p<0.05). CONCLUSION No significant difference was demonstrated in length of stay in hospital/length of stay in the intensive treatment unit and prevalence of mortality between patients originally presenting in TCHT and those presenting in non-TCHT. However, patients transferred from non-TCHT to TCHT had a lower prevalence of mortality. These findings may constitute a valuable benchmark for comparison with results arising after introduction of trauma centres in the UK.

O uso da tomografia computadorizada na triagem da lesão cardíaca penetrante.

“…Penetrating heart injuries represent a significant mortality cause, and can be challenging either from the therapeutic or the diagnostic point of view, since they can be asymptomatic or oligosymptomatic for a variable period after a trauma occurs 6,11,14 . Most studies show that young men are the most struck by penetrating heart injuries, which is in consonance with our outcomes 5,7,8,[14][15][16][17][18] .…”

“…The most frequent mechanism among patients operated due to penetrating heart traumatism is stab wounds, in a proportion ranging from 39% to 81.4% 3,7,8,15 . Necropsy research suggests that firearm wounds (GSW) are the most frequent 2 ones.…”

Diagnostic Accuracy of Chest Ultrasound versus Plain Chest X-ray in Acute Assessment of Traumatic Hemothorax

“…However, in the study conducted by Awais et al (12) penetrating and blunt thoracic trauma was reported in 104 (50.2%) and 103 (49.8%) cases respectively with nearly equal distribution. Furthermore, Khorsandi et al (13) study showed more prevalence in penetrating trauma patients than those with blunt trauma among studied patients.…”

Faecal Carriage of Gram-Negative Multidrug-Resistant Bacteria among Patients Hospitalized in Two Centres in Ulaanbaatar, Mongolia

“…Men are more inclined to trauma and injuries as they pursue riskier activities at the workplace and at home (e.g. [31, 32]), whereas burns are a leading cause of injuries in children in Mongolia [33, 34]. In the BTC we did observe a colonization rate exceeding 50% in all age groups though significantly less in children.…”