Chinese Journal of Traumatology, Vol 16, No 2 (2013)

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Outcome of penetrating cardiac injuries in southern Iran, Shiraz

Janati Mansour, Bolandparvaz Shahram, Salaminia Shirvan, Johari Hamed Ghoddusi, Sabet Babak, Kojuri Javad

Abstract


【Abstract】Objective: Cardiac injuries are one of
the most challenging injuries in the field of trauma surgery.
Their management often requires immediate surgical
intervention, excellent surgical technique and the ability to
provide excellent postoperative critical care to patients. The
aim of this study was to evaluate the outcome and survival
rate of patients with penetrating cardiac injury in southern
Iran, Shiraz.
Methods: From January 2001 to June 2007, medical
records of all patients suffering from penetrating cardiac
injuries were reviewed and their outcomes were investigated.
The inclusion criterion was the presence of a confirmed
penetrating cardiac injury intraoperatively or by autopsy.
Patients with blunt cardiac injuries were excluded from the
study.
Results: The study consisted of 37 patients, including
1 gunshot wound (2.7%), 35 stab wounds (94.6%) and 1 (2.7%)
shotgun wound. The overall survival rate was 76% (28 in
37) and that in stab wound patients was 80%. The collected
data of 9 expired patients revealed 11% death on arrival,
67% hypotensive, and 22% normotensive considering
physiologic presentation. Paired sample test showed sig-nificant correlation between mortality and electrocardio-graphic changes, amount of retained blood in pericardium,
clinical stage and physiologic condition at presentation, as
well as associated injury type (gunshot more than stab
wound).
Conclusion: Our results show that injury mechanism
and initial cardiac rhythm are significant predictors of out-comes in patients with penetrating cardiac injuries. Besides,
gunshot injury and exsanguination are the most important
predictive variables of mortality.
Key words: Heart injuries; Wounds, penetrating;
Heart arrest; Survival

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