Biplab Mishra,Amit Gupta,Sushma Sagar,Maneesh Singhal,Subodh Kumar.[J].Chin J Traumatol,2016,19(6):333-336. [doi]
Traumatic cardiac injury: Experience from a level-1 trauma centre
  
DOI：
KeyWord: Heart injuriesCardiac tamponadeThoracic injuries
FundProject:
Author NameAffiliation
Biplab Mishra Division of Trauma Surgery & Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India 
Amit Gupta Division of Trauma Surgery & Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India 
Sushma Sagar Division of Trauma Surgery & Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India 
Maneesh Singhal Division of Trauma Surgery & Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India 
Subodh Kumar Division of Trauma Surgery & Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India 
Hits:
Download times:
Abstract:
      Purpose: Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI. Methods: Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15. Results: Out of 21 cases of TCI, 6 (28.6%) had isolated and 15 (71.4%) had associated injuries. Ratio between blunt and penetrating injuries was 2:1 with male preponderance. Mean ISS was 31.95. Thirteen patients (62%) presented with features suggestive of shock. Cardiac tamponade was present in 12 (57%) cases and pericardiocentesis was done in only 6 cases of them. Overall 19 patients underwent surgery. Perioperatively 8 (38.1%) patients developed cardiac arrest and 7 developed cardiac arrhythmia. Overall survival rate was 71.4%. Mortality was related to cardiac arrest (p=0.014), arrhythmia (p=0.014), and hemorrhagic shock (p=0.04). The diagnostic accuracy of focused assessment by sonography in trauma (FAST) was 95.24%. Conclusion: High index of clinical suspicion based on the mechanism of injury, meticulous examination by FAST and early intervention could improve the overall outcome.
View Full Text   View/Add Comment  Download reader
Close