Mansour Janati,Shahram Bolandparvaz,Shirvan Salaminia,Hamed Ghoddusi Johari,Babak Sabet,Javad Kojuri.[J].Chin J Traumatol,2013,16(2):89-93. [doi]
Outcome of penetrating cardiac injuries in southern Iran, Shiraz
  
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KeyWord: Heart injuries  Wounds, penetrating  Heart arrest  Survival
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Author NameAffiliation
Mansour Janati Cardiac Surgery Department, Shiraz University of Medical Sciences, Iran 
Shahram Bolandparvaz Trauma Research Center, General Surgery Department, Shiraz University of Medical Sciences, Iran 
Shirvan Salaminia Cardiac Surgery Department, Shiraz University of Medical Sciences, Iran 
Hamed Ghoddusi Johari Trauma Research Center, General Surgery Department, Shiraz University of Medical Sciences, Iran 
Babak Sabet General Surgery Department, Shahid Beheshti University of Medical Sciences, Iran 
Javad Kojuri Cardiology Department, Shiraz University of Medical Sciences, Iran 
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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 stabwounds (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 significant correlation between mortality and electrocardiographic 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 outcomes in patients with penetrating cardiac injuries. Besides, gunshot injury and exsanguination are the most important predictive variables of mortality.
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