Penetrating cardiac injury: factors affecting outcomes in a developing country

ABSTRACT The purpose of this investigation was to evaluate factors affecting the outcome following penetrating cardiac trauma in a developing country and to compare our results with others in developed countries. Analysis of the cause of trauma, age, sex, different tools of investigations used, concomitant organ injuries, SBP, GCS, ISS, RTS, TRISS and mortality were performed. This study included 35 patients; all were males. Mortality rate was 22.8%. It was significant with low SBP (p =0.021), GCS ˂ 9 (p =0.02), non-presentation with tamponade (p = 0.023), low ISS (p =0.02), low RTS (p =0.007), low TRISS (p = 0.003), less blood transfusion (p =0.001) and longer time before entrance to OR (p= 0.019). Meanwhile, mortality were not significant with age (p =0.33), mechanism of injury (p =0.16), other associated injuries (p =0.16) or associated intra-abdominal injuries (p= 0.16). Rapid assessment and prompt surgical intervention may reduce mortality. Even in a developing country, mortality rates could reach those in developed countries depending on clinical skills and accessible technology tools. Key words: Thoracic injuries, penetrating cardiac injuries, thoracic trauma REFERENCES Alexander, B., Dan, H. (2012). Negative FAST and echocardiography in penetrating cardiac injuries decompressing to the chest and peritoneal cavities. Injury Extra, 43: 139-141. Bruno, M.T.P., Vitor , B.N., Thiago, R.A.C., Marcelo, P.V.¸ Orlando, P., Gustavo, P.F. (2013). Penetrating cardiac trauma: 20-y experience from a university teaching hospital. Journal of Surgical Research, 30: e1-e6. Ceviker, K., Tulay, C., Sahinalp, S., Atlı, H.F. (2014). Factors affecting mortality in cardiac injury of penetrating thorax trauma: a retrospective study. Gaziantep Med J, 20: 35-41. Clarke, D.L., Muhammed, A., Reddy, K., Thomson, S.R. (2011). Emergency operation for penetrating thoracic trauma in a metropolitan surgical service in South Africa. J Thorac Cardiovasc Surg, 142: 563-568. Cury, F., Baitello, A.L., Echeverria, R.F., Espada, P.C., Pereira, de Godoy J.M. (2009). Rates of thoracic trauma and mortality due to accidents in Brazil. Ann Thorac Med, 4: 25-26. Niall, M., Kieran. M. (2011). Penetrating thoracic trauma. Surgery, 29: 227-230. O’Connor, J., Ditillo, M., Scalea, T. (2009). Penetrating cardiac injury. J R Army Med Corps, 155: 185-189. Onan, B., Demirhan R., Öz, K., Onan, İ.S. (2011). Cardiac and great vessel injuries after chest trauma: our 10-year experience. Turkish Journal of Trauma & Emergency Surgery, 17:423-429. Serdar, O., Refik U., Alper, A., Gungor, A., Cemal, O. (2011). Urgent thoracotomy for penetrating chest trauma: Analysis of 158 patients of a single center. Injury, Int J Care Injured, 42: 900-904. Tariq, U.M., Faruque, A. Ansari, H., Ahmad, M., Rashid, U., Perveen, S. (2011). Changes in the patterns, presentation and management of penetrating chest trauma patients at a level II trauma center in Southern Pakistan over the last two decades. Interact Cardio vascThoracSurg, 12: 24-27