Review of 1198 cases of penetrating cardiac trauma

Campbell, N. C.; Thomson, Sandie; Muckart, D. J. J.; Meumann, C. M.; Middelkoop, I. Van; Botha, J. B. C.

doi:10.1002/bjs.1800841225

Cited by 141 publications

(138 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In agreement with others, our results have shown that victims of penetrating cardiac injuries are predominantly young males [1,3,14,16,20,24,25,30].…”

Section: Discussionsupporting

confidence: 93%

“…Such a high percentage of survivors might mean that a significant number of injured persons did not reach the hospital in time. Similar observations are also presented by other authors [4,16,24]. In fact, the number of casualties with fatal outcome prior to admission is not known to us; however, some authors suggest that only 6-20% of victims reach hospital alive.…”

Section: Discussionsupporting

confidence: 88%

“…In fact, the number of casualties with fatal outcome prior to admission is not known to us; however, some authors suggest that only 6-20% of victims reach hospital alive. The overall survival rate of penetrating heart trauma is estimated to be 10-92% [3,16,21,[24][25][26][27]. It depends not only on the severity of the injury but on other circumstances as well (population area, median time taken from injury to emergency department admission, associated injuries, etc.…”

Section: Discussionmentioning

confidence: 99%

“…However, this time was limited to the area within a radius of 3.2 km. But according to the data from South Africa and India this time is usually about 2 hours [16].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous publications on the subject of injuries to the heart have been published; however, despite huge advances in medicine, only 6-30% of patients reach hospital alive [4,14,15]. Also, most often they reach the hospital in deep hemodynamic shock [4,16,17].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

Jagelavičius¹,

Budra²,

Jovaišas³

et al. 2013

kitp

View full text Add to dashboard Cite

1 StreszczenieWstęp: Rany kłute serca są dramatycznymi, prowadzącymi do zgonu urazami. Na ogół zdarzają się u ludzi młodych. Więk-szość ofiar umiera przed przyjęciem do szpitala. Cel pracy: Celem pracy było określenie czynników decydują-cych o wynikach leczenia i rokowaniu chorych z ranami kłu-tymi serca. , p = 0,031), wyższy stopień urazu (IV-VI) (90,5% vs 29,7%, p < 0,001), uraz prawego przedsionka (28,6% vs 8,5%, p = 0,014) lub lewej komory (42,9% vs 23,0%, p = 0,049) i epizody zatrzymania krążenia (85,7% vs 7,9%, p < 0,001). Niezależnym prognostycznym czynnikiem przeżycia była obecność wszystkich czynników SOL oraz młodszy wiek. Wyższy stopień urazu (IV-VI) oraz zatrzymanie krążenia w trakcie operacji były niezależnymi czynnikami zgonu. Wnioski: Prekursorami złego rokowania były niższe wartości ciśnienia tętniczego oraz brak co najmniej jednego z czynni- CARDIAC SURGERY AbstractBackground: Penetrating cardiac injuries are a dramatic and lethal form of trauma. They are usually sustained by young people. The majority of victims die before reaching the hospital. Aim of the study: The aim of the study was to establish prognostic criteria for the outcome of penetrating cardiac injury. Material and methods: We retrospectively reviewed the records of 186 patients with penetrating cardiac injuries who were operated on during the first 24 hours after admission. Results: The mean age was 33 (interquartile range (IQR): 26-44) years. 88.7% of victims were male. The mean time from the moment of trauma to arrival at the hospital in Vilnius city was 60 minutes (IQR: 50-91), whereas from the Vilnius region it was 240 (IQR: 82-390) minutes. The vast majority of patients (176/186, 94.6%) sustained stab wounds. Hemopericardium or cardiac tamponade (142/186, 76.3%) usually was found at the operation. Right ventricle was the most often injured heart chamber (75/186, 40.3%). Associated injuries were evaluated in 57.0% (106/186) of patients. The survival rate on discharge was 88.7%. Compared to non-survivors, the lucky patients had a higher systolic blood pressure on admission (94 mm Hg (IQR: 70-120) versus (vs.) 70 mm Hg (IQR: 0-80), p < 0.001). Survivors had all signs of life (SOL) more often (82.4% vs. 42.9%, p < 0.001), whereas more frequent findings in non-survivors were the following: tamponade (52.4% vs. 29.1%, p = 0.031), higher grade (IV-VI) of injury (90.5% vs. 29.7%, p < 0.001), injured right atrium (28.6% vs. 8.5% p = 0.014) or left ventricle (42.9% vs. 23.0%, p = 0.049) and an episode of heart arrest (85.7% vs. 7.9%, p < 0.001). Independent prognostic factors of survival were the presence of all SOL and younger age. Higher grade (IV-VI) of heart injury and heart arrest during surgery independently predicted mortality. Conclusions: According to our data, lower arterial blood pressure and absence of one or more SOL on admission, cardiac tamponade, higher grade injury, injured right atrium and asystole during operation are true precursors of fatal outcome.

show abstract

“…In agreement with others, our results have shown that victims of penetrating cardiac injuries are predominantly young males [1,3,14,16,20,24,25,30].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

“…However, this time was limited to the area within a radius of 3.2 km. But according to the data from South Africa and India this time is usually about 2 hours [16].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

CARDIAC SURGERY Penetrating cardiac injuries: 28-year data analysis

Jagelavičius¹,

Budra²,

Jovaišas³

et al. 2013

kitp

View full text Add to dashboard Cite

show abstract

Postdischarge Complications After Penetrating Cardiac Injury

et al. 2011

View full text Add to dashboard Cite

Hypothesis: A significant rate of postdischarge complications is associated with penetrating cardiac injuries. Design: Retrospective trauma registry review. Setting: Level I trauma center. Patients: All patients sustaining penetrating cardiac inju-riesbetweenJanuary2000andJune2010.Patientdemographics, clinical data, operative findings, outpatient follow-up, echocardiogram results, and outcomes were extracted. Main Outcome Measures: Cardiac-related complications and mortality. Results: During the 10.5-year study period, 406 of 40 706 trauma admissions (1.0%) sustained penetrating cardiac injury. One hundred nine (26.9%) survived to hospital discharge. The survivors were predominantly male (94.4%), with a mean (SD) age of 30.8 (11.7) years, and 74.3% sustained a stab wound. Signs of life were present on admission in 92.6%. Cardiac chambers involved were the right ventricle (45.9%), left ventricle (40.3%), right atrium (10.1%), left atrium (0.9%), and combined (2.8%). Inhospital follow-up was available for a mean (SD) of 11.0 (9.8) days (median, 8 days; range, 3-65 days) and outpatient follow-up was available in 46 patients (42.2%) for a mean (SD) of 1.9 (4.1) months (median, 0.9 months; range, 0.2-12 months). Abnormal echocardiograms demonstrated pericardial effusions (9), abnormal wall motion (8), decreased ejection fraction (Ͻ45%) (8), intramural thrombus (4), valve injury (4), cardiac enlargement (2), conduction abnormality (2), pseudoaneurysm (1), aneurysm (1), and septal defect (1). No operative intervention was required for the complications. The 1-year and 9-year survival rates were 97% and 88%, respectively. Conclusions: Penetrating cardiac injuries remain highly lethal. A significant rate of cardiac complications can be expected and follow-up echocardiographic evaluation is warranted prior to discharge. The majority of these, however, can be managed without the need for surgical intervention.

show abstract