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Penetrating cardiac injuries: a 13-year retrospective evaluation from a Brazilian trauma center

Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil

*Corresponding author: Divisão de Cirurgia Torácica e Cardiovascular, Hospital das Clinicas-FMRP-USP, CEP:14048-900, Ribeirão Preto, SP-Brasil. Tel./fax: +55-16-602-2497.

E-mail address: alfredo{at}fmrp.usp.br (A.J. Rodrigues).

To present our experience with penetrating cardiac injuries. We have retrospectively reviewed the records of 70 victims of penetrating cardiac injuries. A logistic regression has been performed in order to determine the association between death and clinical predictors. Penetrating injuries consisted of 43 stab wounds (61.4%) and 27 (38.6%) gunshot injuries (P=0.72). There were 63 (90%) male and 7 female (10%, P<0.001) victims. The mean age was 27.36±11.51, ranging from 3 to 65 years. The overall mortality was 32.9%, 47.8% for gunshot wounds and 52.2% for stab wounds (P=0.266). Eight victims (11.4%) had associated intra-thoracic great vessel injuries and 17 (24.3%) presented associated intra-abdominal organ injuries. The incidence of injured chamber was: right ventricle 37.1%, right atrium 27.1%, left ventricle 25.7%, and left atrium 5.7%. Non-survivors had lower systolic blood pressure (37.50±39.18 mmHg) than survivors (79.04±41.04 mmHg; P<0.001) upon arrival at the hospital. Thirteen non-survival (56.5%) and 10 (21.3%) survival victims had systolic blood pressure (SBP) 50 mmHg (P=0.001). The level of systolic blood pressure (SBP50 mmHg) and consciousness upon arrival at the hospital are predictors of outcome in victims of penetrating cardiac injuries.

Key Words: Penetrating cardiac injuries; Cardiac wounds; Heart wounds; Penetrating chest wounds; Penetrating chest trauma