Five Thousand Seven Hundred Sixty Cardiovascular Injuries in 4459 Patients

Abstract

Large epidemiologic analyses of cardiovascular injuries have been limited to studies of military campaigns compiled from many surgeons working in many hospitals with variable protocols. A detailed civilian vascular trauma registry provides a unique opportunity for an epidemiologic evolutionary profile. During the last 30 years in a single civilian trauma center directed by a consistent evaluation and treatment philosophy, 4459 patients were treated for 5760 cardiovascular injuries. Eighty-six per cent of the patients were male, and the average age was 30.0 years. Penetrating trauma was the etiology in more than 90% (GSW,51.5%; SW,31.1%; SGW,6.8%). All other injuries were iatrogenic or secondary to blunt trauma. Truncal injuries (including the neck) accounted for 66% of all injuries treated, while lower extremity injuries (including the groin) accounted for only 19%. Injuries to the abdominal vasculature accounted for 33.7% of the injuries. One thousand fifty-seven patients had 2 or more concurrent vascular injuries, and 32 patients had 4 or more separate vascular injuries. The 27 patients-per-year average of the early 1960s has risen to a current average of 213 patients per year. Economic and population factors influenced wounding agents and injury patterns during the evaluation period. This extensive civilian series presents epidemiologic profiles that are distinctly different from military reports and serves as a guide for current trauma center and health planners.

Cardiac and great vessel injuries after chest trauma: our 10-year experience

“…[7] Similarly, in our experience, great vessel injuries in penetrating trauma were mostly due to stab wounds. These injuries frequently involved the subclavian vein, followed by the superior vena cava and innominate vein.…”

External Iliac Artery Transection Managed by Iliofemoral Bypass Grafting Using Temporary Balloon Occlusion

“…For a more clear and improved option than aortic clamping, more studies with hemorrhage-related mortality are needed [5]. Iliac vascular injuries represent 11% of cardiovascular injuries, and 26% of those have combined injuries such as a pelvic bone fracture and internal organ injuries [11,12]. An iliac vascular injury can cause a massive hemorrhage and result in hypovolemic shock.…”

Fatores prognósticos de mortalidade em pacientes com trauma cardíaco que chegam à sala de cirurgia

“…Com o aumento da violência urbana, a literatura vem mostrando uma grande incidência de lesões cardiovasculares e em tórax 15 . Em Pernambuco, 9% das mortes violentas ocorridas em 1991 apresentaram ferimentos no coração 18 .…”

“…Esta lesão é produzida usualmente por arma branca, uma vez que esta câmara apresenta-se na face anterior do tórax, próxima à parede, sendo suscetível aos ataques frontais com estes instrumentos que apresentam baixo poder de penetração. Esta é considerada a lesão cardíaca mais fácil de lidar, uma vez que não há comprometimento de lesão tecidual e a própria musculatura ventricular poderá tamponá-la parcialmente além do fácil acesso para o cirurgião 4,7,13,15,16,23,34,35 . As lesões atriais são consideradas de maior gravidade pelo sangramento contí-nuo que apresentam por não haver possibilidade de tamponamento pela sua fina parede.…”