Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia

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...

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Autores Principales: Isaza-Restrepo, Andres, Bolívar-Sáenz, Dínimo José, Tarazona Lara, Marcos Manuel, Tovar Cuevas, José Rafael
Formato: Artículo (Article)
Lenguaje:Inglés (English)
Publicado: 2017
Materias:
Acceso en línea:https://repository.urosario.edu.co/handle/10336/21905
https://doi.org/10.1186/s13017-017-0138-1
id ir-10336-21905
recordtype dspace
institution EdocUR - Universidad del Rosario
collection DSpace
language Inglés (English)
topic Varias ramas de la medicina, Cirugía
Cardiac trauma
Penetrating chest wounds
Heart injury
Penetrating wounds
Cardiac tamponade
Pericardial window
Sternotomy
Case series
spellingShingle Varias ramas de la medicina, Cirugía
Cardiac trauma
Penetrating chest wounds
Heart injury
Penetrating wounds
Cardiac tamponade
Pericardial window
Sternotomy
Case series
Isaza-Restrepo, Andres
Bolívar-Sáenz, Dínimo José
Tarazona Lara, Marcos Manuel
Tovar Cuevas, José Rafael
Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia
description 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. © 2017 The Author(s).
format Artículo (Article)
author Isaza-Restrepo, Andres
Bolívar-Sáenz, Dínimo José
Tarazona Lara, Marcos Manuel
Tovar Cuevas, José Rafael
author_facet Isaza-Restrepo, Andres
Bolívar-Sáenz, Dínimo José
Tarazona Lara, Marcos Manuel
Tovar Cuevas, José Rafael
author_sort Isaza-Restrepo, Andres
title Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia
title_short Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia
title_full Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia
title_fullStr Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia
title_full_unstemmed Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia
title_sort penetrating cardiac trauma: analysis of 240 cases from a hospital in bogota, colombia
publishDate 2017
url https://repository.urosario.edu.co/handle/10336/21905
https://doi.org/10.1186/s13017-017-0138-1
_version_ 1667195671053074432
spelling ir-10336-219052020-05-13T19:47:36Z Penetrating cardiac trauma: Analysis of 240 cases from a hospital in Bogota, Colombia Isaza-Restrepo, Andres Bolívar-Sáenz, Dínimo José Tarazona Lara, Marcos Manuel Tovar Cuevas, José Rafael Varias ramas de la medicina, Cirugía Cardiac trauma Penetrating chest wounds Heart injury Penetrating wounds Cardiac tamponade Pericardial window Sternotomy Case series 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. © 2017 The Author(s). 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. © 2017 The Author(s). 2017-06-12 2020-05-07T22:19:55Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 1749-7922 https://repository.urosario.edu.co/handle/10336/21905 https://doi.org/10.1186/s13017-017-0138-1 eng info:eu-repo/semantics/openAccess application/pdf
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