Penetrating cardiac trauma

analysis of 240 cases from a hospital in Bogota, Colombia

Andres Isaza-Restrepo, Dínimo José Bolívar-Sáenz, Marcos Tarazona-Lara, José Rafael Tovar

Resultado de la investigación: Contribución a RevistaArtículo

2 Citas (Scopus)

Resumen

BACKGROUND: Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management.

METHODS: This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogotá, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed.

RESULTS: The study included 240 cases: 96.2% males, mean age of 27.8 years. Overall mortality was 14.6%: 11.7% from stab wounds and 41.2% from gunshot wounds. Upon admission, 44% had a normal hemodynamic status and 67% had cardiac tamponade. About 32% had Grade II injuries and 29% Grade IV injuries. In 85% of the cases, there were ventricular compromise and 55% of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20% being higher for gunshot wounds (54.5%) than for stab wounds (18%) (p = 0.0120).

CONCLUSIONS: The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach.

Idioma originalEnglish (US)
Páginas (desde-hasta)26
PublicaciónWorld Journal of Emergency Surgery
Volumen12
DOI
EstadoPublished - 2017
Publicado de forma externa

Huella dactilar

Colombia
Wounds and Injuries
Stab Wounds
Mortality
Gunshot Wounds
Cardiac Tamponade
Sternotomy
Trauma Centers
Heart Atria
Hospitalization
Referral and Consultation
Survival Rate
Hemodynamics
Demography

Citar esto

Isaza-Restrepo, Andres ; Bolívar-Sáenz, Dínimo José ; Tarazona-Lara, Marcos ; Tovar, José Rafael. / Penetrating cardiac trauma : analysis of 240 cases from a hospital in Bogota, Colombia. En: World Journal of Emergency Surgery. 2017 ; Vol. 12. pp. 26.
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abstract = "BACKGROUND: Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management.METHODS: This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogot{\'a}, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed.RESULTS: The study included 240 cases: 96.2{\%} males, mean age of 27.8 years. Overall mortality was 14.6{\%}: 11.7{\%} from stab wounds and 41.2{\%} from gunshot wounds. Upon admission, 44{\%} had a normal hemodynamic status and 67{\%} had cardiac tamponade. About 32{\%} had Grade II injuries and 29{\%} Grade IV injuries. In 85{\%} of the cases, there were ventricular compromise and 55{\%} of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20{\%} being higher for gunshot wounds (54.5{\%}) than for stab wounds (18{\%}) (p = 0.0120).CONCLUSIONS: The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach.",
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Penetrating cardiac trauma : analysis of 240 cases from a hospital in Bogota, Colombia. / Isaza-Restrepo, Andres; Bolívar-Sáenz, Dínimo José; Tarazona-Lara, Marcos; Tovar, José Rafael.

En: World Journal of Emergency Surgery, Vol. 12, 2017, p. 26.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - Penetrating cardiac trauma

T2 - analysis of 240 cases from a hospital in Bogota, Colombia

AU - Isaza-Restrepo, Andres

AU - Bolívar-Sáenz, Dínimo José

AU - Tarazona-Lara, Marcos

AU - Tovar, José Rafael

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management.METHODS: This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogotá, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed.RESULTS: The study included 240 cases: 96.2% males, mean age of 27.8 years. Overall mortality was 14.6%: 11.7% from stab wounds and 41.2% from gunshot wounds. Upon admission, 44% had a normal hemodynamic status and 67% had cardiac tamponade. About 32% had Grade II injuries and 29% Grade IV injuries. In 85% of the cases, there were ventricular compromise and 55% of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20% being higher for gunshot wounds (54.5%) than for stab wounds (18%) (p = 0.0120).CONCLUSIONS: The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach.

AB - BACKGROUND: Trauma characteristics and its management is influenced by socioeconomic context. Cardiac trauma constitutes a challenge for surgeons, and outcomes depend on multiple factors including initial care, characteristics of the wounds, and surgical management.METHODS: This is a retrospective cross-sectional case series of patients with penetrating cardiac injuries (PCI) from January 1999 to October 2009 who underwent surgery in a trauma referral center in Bogotá, Colombia. Demographic variables, trauma characteristics, treatment, and outcomes were analyzed.RESULTS: The study included 240 cases: 96.2% males, mean age of 27.8 years. Overall mortality was 14.6%: 11.7% from stab wounds and 41.2% from gunshot wounds. Upon admission, 44% had a normal hemodynamic status and 67% had cardiac tamponade. About 32% had Grade II injuries and 29% Grade IV injuries. In 85% of the cases, there were ventricular compromise and 55% of patients had associated lesions. In 150 cases, a pericardial window was performed. Highest mortality occurred in wounds to the right atrium. In tamponade patients, mortality was 20% being higher for gunshot wounds (54.5%) than for stab wounds (18%) (p = 0.0120).CONCLUSIONS: The study evidenced predominance of stab wounds. Based on characteristics of the trauma, patients, and survival rate, there is most likely a high pre-hospitalization mortality rate. The difference in mortality due to stab wounds and those produced by gunshots was more related to technical difficulties of the surgical repair than with the type of injury established by the Injury Grading Scale. Mortality was higher in patients with cardiac tamponade. Surgical management was satisfactory using pericardial window as the diagnostic method and sternotomy as the surgical approach.

U2 - 10.1186/s13017-017-0138-1

DO - 10.1186/s13017-017-0138-1

M3 - Article

VL - 12

SP - 26

JO - World Journal of Emergency Surgery

JF - World Journal of Emergency Surgery

SN - 1749-7922

ER -