Major Thoracic Vessels and Cardiac Trauma: Case Series from a centre in a developing country

Fatimi, Saulat Hasnain; Hanif, Hashim Muhammad; Awais, Anum; Shamsi, Ghina; Muzaffar, Marium

doi:10.5505/tjtes.2012.39225

Cited by 7 publications

(11 citation statements)

References 28 publications

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“…14 In this study, the total mortality rate was 12.5% of cases: five patients died during surgical procedures and 28 from complications caused by the traumas. This is a very significant mortality rate, but is in line with the global literature 1,4,12,15,16 and with a study by Markov et al 17 who stated that this type of trauma causes up to 8% mortality in severe arterial injuries.…”

Section: Discussionsupporting

confidence: 70%

Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

Soares¹,

Bastos²,

Junior³

et al. 2015

J. vasc. bras.

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Background: Vascular traumas are associated with high morbidity rates. Objective: To report the characteristics of vascular traumas in the Brazilian state of Pará, in trauma victims treated at the Hospital Metropolitano de Urgência e Emergência (HMUE), from 2011 to 2013. Method: This was a descriptive, cross-sectional, retrospective and quantitative study that analyzed data on sex, age group, geographical origin, time waiting for care, mechanism of trauma, clinical status, anatomic site of injury, prevalence of associated fractures, vascular structures injured, types of vascular injury, principal types of surgery, early postoperative outcomes, level of amputation, number of deaths, length of hospital stay and multidisciplinary care for 264 medical records. Results: The majority of victims were male and the most common age group was from 16 to 30 years. The majority of cases were from towns other than the state capital, accounting for 169 cases (64.02%). The principal mechanism of injury was firearm wounding -110 (41.67%) followed by cold weapon wounds -65 (24.62%) and traffic accidents -42 (15.91%). The segments of the body and the vascular structures most often injured were lower limbs -120 (45.45%) and injuries to the popliteal and femoral arteries and veins. The most common clinical presentation at admission was hemorrhage -154 (58.33%). The most common surgeries were ligatures of veins and arteries. There were 163 (61.74%) hospital discharges and 33 (12.5%) deaths. Conclusions: The greatest prevalence observed was related to traumas caused by urban violence. Victims were most frequently male, of working age and from towns other than the capital of the state of Pará.

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Section: Discussionsupporting

confidence: 70%

Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

Soares¹,

Bastos²,

Junior³

et al. 2015

J. vasc. bras.

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“…As the incidence of trauma is rising all over the world, it is crucial that surgeons be prepared to deal with vascular injuries [2]. These injuries are associated to high mortality and morbidity in civilian populations of urban areas and militaries on the battlefield [6] [27]- [30].…”

Section: Discussionmentioning

confidence: 99%

Vascular Trauma in the Amazon Region: A Two Years Cases Review From a Single Institution

Góes¹,

Rodrigues²,

Braga³

et al. 2014

Health

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Introduction: Vascular injuries are among the main mechanisms of death in trauma. In Brazil, the general surgeon is in charge of emergencies procedures in most hospitals, but many times these surgeons are not familiarized with more complex vascular surgical techniques that often require a vascular surgeon. Pará State is the most populated one in the Brazilian Amazon region and a single hospital with vascular surgeons permanently on call is available. Objectives: To evaluate demographic data on vascular trauma victims; to establish the mechanism, anatomic location, injury pattern and surgical techniques used to manage the vascular lesions treated at the Metropolitan Emergency Hospital; to ascertain associated non-vascular injuries and victim's clinical outcome. Methods: Medical records retrospective analysis of patients treated for vascular injuries from February 2011 to February 2013 at the institution in case. All arterial and venous injuries were analyzed. Patients who were not operated by the vascular surgery team, iatrogenic injuries and those who underwent primary or sustained traumatic amputation were excluded. Results: 173 cases; 95.95% were male; 54.90% were between 25 and 49 years; penetrating trauma mechanisms were found in 88.44%; lower limb was the most affected topography (41.50%); the most injured vessels were the superficial femoral and ulnar arteries (in 15.75% of cases each) and the superficial femoral vein (17.77%); autologous vein graft was the most performed technique for arterial repair (36.57%) and ligature was performed in 85.00% of venous trauma; amputation rate was 15.60% and mortality rate was 6.35%. Conclusions: Vascular injuries occurred predominantly in men from 24 to 49 years old; penetrating mechanisms were most frequent; lower limb was the most affected topography; the most frequently injured vessels were the ulnar and superficial femoral arteries and the superficial femoral vein; complete vessel transection was the most common injury pattern; arterial trauma was most frequently treated by autologous venous graft

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“…Fatimi et al [7] reported, the average time lag between injury and arrival to the hospital was 2.17 hours, and the time lag between arrival to the hospital and incision time was 32.13 minutes. In our cases, the median time from field to trauma bay was 63.50 minutes (quartiles 36.00, 121.75).…”

Section: Discussionmentioning

confidence: 99%

“…And speedy and optimal surgery is essential to improve outcome, the delay can adversely affect the outcome regarding both morbidity and mortality [7].…”

Section: Discussionmentioning

confidence: 99%

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Emergency Surgical Management of Traumatic Cardiac Injury in Single Institution for Three Years

Joo

Sung

Jeon

et al. 2017

Journal of Trauma and Injury

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Purpose: Thoracic traumas represent 10-15% of all traumas and are responsible for 25% of all trauma mortalities. Traumatic cardiac injury (TCI) is one of the major causes of death in trauma patients, rarely present in living patients who are transferred to the hospital. TCI is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. This study is to describe our experiences about emergency cardiac surgery in TCI. Methods: This is a retrospective clinical analysis of patients who had undergone emergency cardiac surgery in our trauma center from January 2014 to December 2016. Demographics, physiologic data, mechanism of injuries, the timing of surgical interventions, surgical approaches and outcomes were reviewed. Results: The number of trauma patients who arrived at our hospital during the study period was 9,501. Among them, 884 had chest injuries, 434 patients were evaluated to have over 3 abbreviated injury scale (AIS) about the chest. Cardiac surgeries were performed in 18 patients, and 13 (72.2%) of them were male. The median age was 47.0 years (quartiles 35.0, 55.3). Eleven patients (61.1%) had penetrating traumas. Prehospital cardiopulmonary resuscitations (CPR) were performed in 4 patients (22.2%). All of them had undergone emergency department thoracotomy (EDT), and they were transferred to the operating room for definitive repair of the cardiac injury, but all of them expired in the intensive care unit. Most commonly performed surgical incision was median sternotomy (n=13, 72.2%). The majority site of injury was right ventricle (n=11, 61.1%). The mortality rate was 22.2% (n=4). Conclusions: This study suggests that penetrating cardiac injuries are more often than blunt cardiac injury in TCI, and the majority site of injury is right ventricle. Also, it suggests prehospital CPR and EDT are significantly responsible for high mortality in TCI.

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Major Thoracic Vessels and Cardiac Trauma: Case Series from a centre in a developing country

Cited by 7 publications

References 28 publications

Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

Vascular injuries in the state of Pará, Brazil, 2011-2013 and their relation with demographic and clinical variables

Vascular Trauma in the Amazon Region: A Two Years Cases Review From a Single Institution

Emergency Surgical Management of Traumatic Cardiac Injury in Single Institution for Three Years

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