Outcome of major cardiac injuries at a Canadian trauma center

Alanezi, Khaled; Milencoff, G. Scott; Baillie, Frank; Lamy, André; Urschel, John D.

doi:10.1186/1471-2482-2-4

Cited by 17 publications

(20 citation statements)

References 16 publications

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“…The severity of injury of different organs could be estimated with various scores and classifications after a trauma (5,7). Successful correlations with survival in this scoring system have been shown in many studies (1,5,20). Although, HIS grade was statistically significantly correlated with mortality, LIS was not and PTTI scores were significantly higher in non-survivors compared to the survivors in the present study.…”

Section: Discussioncontrasting

confidence: 51%

Factors affecting mortality in cardiac injury of penetrating thorax trauma: a retrospective study

Çeviker¹,

Tülay²,

Şahinalp³

et al. 2014

Gaziantep Med J

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In this study, we investigated the factors affecting survival in patients who were operated for penetrating cardiac and vascular injuries due to penetrating thoracic trauma. Ninety-six patients with penetrating thoracic trauma (90 males, 6 females, mean age 26±8 years) who were admitted to our clinic between January 2010 and January 2013 were recruited to the study. Retrospective evaluation of the cause of trauma, age, gender, concomitant organ injuries, Rohman classification, Glasgow coma score, Heart Injury Scale, Lung Injury Scale, penetrating thoracic trauma index, surgical intervention, and mortality were determined. The mortality rate was 39.6% in our study and correlated with cardiac tamponade, systolic blood pressure, heart rate, Glasgow coma score, heart injury scale and penetrating thoracic trauma index. However, a significant relationship was found only between mortality and systolic blood pressure in a binary logistic regression model (p=0.024). In patients with penetrating thoracic trauma, rapid assessment and management of fluid and blood resuscitation that can hold the systolic blood pressure above 80 mmHg and prompt surgical intervention may reduce mortality and may affect the outcomes in penetrating cardiac and other major vascular injuries. Keywords: Cardiac wounds; penetrating cardiac injuries; penetrating chest wounds Özet Bu çalışmada, sadece penetran toraks travması olan, kardiyak ve büyük damar hasarlanması nedeni ile ameliyat edilen hastalarda sağ kalıma etki eden faktörler incelenmiştir. Ocak 2010-Ocak 2013 yılları arasında acil servise penetran toraks travması nedeni ile başvuran 632 hasta dosyası retrospektif olarak incelenmiş ve 96 hasta (90 erkek ve 6 kadın, ortalama yaş 26±8 yıl) çalışmaya alınmıştır. Hastaların yaşı, cinsiyeti, yaralanma şekli, eşlik eden diğer yaralanmaları, Rohman sınıflaması, Glasgow koma skorlaması (GKS), kalp hasar skalası, akciğer hasar skalası, penetran toraks travma sınıflaması, uygulanan cerrahi girişim ve mortaliteleri incelenmiştir. Çalışmadaki mortalite oranı %39.6 olarak bulunmuştur. Mortalite; kardiyak tamponad, sistolik arter basıncı, kalp hızı, Glasgow koma skoru, kalp hasar skalası ve penetran toraks travma sınıflaması ile korole bulunurken ikili lojistik regresyon modellemesinde sadece sistolik arter basıncının 80 mmHg altında oluşu mortalite ile ilişkili bulunmuştur (p=0.024). Penetran toraks travması bulunan hastalarda hızlı klinik değerlendirme sonrasında sistolik arter basıncını 80 mmHg üstünde tutacak şekilde sıvı resüsitasyonu ve kan replasmanı yapılması ve hızlı cerrahi müdahale mortaliteyi düşürebilir ve penetran kalp ve damar yaralanması olan hastaların sağ kalımına olumlu etki edebilir. Anahtar kelimeler: Kardiyak yaralanma; penetran kalp yaralanması; penetran göğüs travması

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Section: Discussioncontrasting

confidence: 51%

Factors affecting mortality in cardiac injury of penetrating thorax trauma: a retrospective study

Çeviker¹,

Tülay²,

Şahinalp³

et al. 2014

Gaziantep Med J

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“…12 Alanezi et al reported on major cardiac injuries over a 9-year period and found 27 cases, of which 11 (40.7%) underwent an EDT. 13 Only one patient (9.1%) who underwent an EDT survived. 13 As previously mentioned, Passos et al reported on outcomes of EDTs at a large level 1 trauma centre in Toronto, Ontario.…”

Section: Discussionmentioning

confidence: 98%

“…13 Only one patient (9.1%) who underwent an EDT survived. 13 As previously mentioned, Passos et al reported on outcomes of EDTs at a large level 1 trauma centre in Toronto, Ontario. 11 The authors reported a survival rate of just 2.4% for 123 EDTs performed.…”

Section: Discussionmentioning

confidence: 98%

“…Our study is an important one because there have been only three studies to date that describe the outcome of an EDT at Canadian trauma centres. [11][12][13] Karmy-Jones et al published data on penetrating cardiac injury in Edmonton over a 2-year period with only eight patients identified, of which three (38%) survived. 12 Six of these (75%) underwent an EDT, of which two (33.3%) survived.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of emergency department thoracotomy in a tertiary care Canadian trauma centre

Owen

Sne

Coates

et al. 2015

CJEM

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Objective: Emergency department thoracotomy (EDT) is a rare and potentially life-saving intervention performed for trauma patients in extremis. EDT is rare at Canadian trauma centres because of our infrequent occurrence of penetrating trauma. This study was undertaken to evaluate outcomes at a Canadian level 1 trauma facility and compare survival to large published datasets. Also, we evaluated the appropriateness of an EDT performed at our centre based on published national guidelines. Methods: Retrospective medical record review of all patients undergoing an EDT during their resuscitation in the emergency department. Records were identified using our trauma registry, and all charts were manually reviewed. The primary outcome was survival to hospital discharge. Results: Over a 20-year period, 58 EDTs were performed with 6 (10.3%) survivors. Patients undergoing an EDT secondary to penetrating trauma had the highest survival (5 of 24 patients or 20.8% survival) compared to patients undergoing an EDT for blunt trauma (1 of 34 patients or 2.9% survival). Patients undergoing an EDT who had not suffered cardiac arrest represented the group with the highest survival rate (3 of 6 patients or 50% survival). The majority of EDTs (79.3%) were indicated, and no patient undergoing an EDT survived if it was performed outside of published guidelines. Conclusions: Survival following an EDT in our small, regional trauma centre is consistent with survival rates from larger published datasets. An EDT should continue to be performed under accepted clinical indications. RÉSUMÉObjectifs: La thoracotomie pratiquée au service des urgences (TSU) est une intervention rare et potentiellement salvatrice chez les grands blessés qui arrivent dans un état gravissime au service des urgences (SU). La TSU est pratiquée rarement dans les centres de traumatologie en raison de la faible fréquence des traumas par pénétration. L'étude visait à évaluer les résultats de la TSU pratiquée dans un centre de traumatologie de niveau 1 au Canada et à comparer la survie à celle relevée dans de grands ensembles de données publiés. De plus, les auteurs voulaient évaluer la pertinence de la TSU pratiquée dans leur centre en fonction des lignes directrices nationales, publiées. Méthode: Il s'agit d'un examen rétrospectif des dossiers médicaux de tous les patients ayant subi une TSU durant les manoeuvres de réanimation au SU. La recherche des dossiers s'est faite à l'aide du registre des traumas de l'établissement concerné, et tous les dossiers ont fait l'objet d'un examen manuel. Le principal critère d'évaluation était la survie au moment de la sortie de l'hôpital. Résultats: Sur une période de 20 ans, 58 TSU ont été effectuées, dont 6 (10,3 %) se sont révélées fructueuses. Les patients ayant subi une TSU à la suite d'un trauma par pénétration ont connu le plus haut taux de survie (5 patients sur 24 ou taux de survie de 20,8 %) comparativement aux patients ayant subi une TSU à la suite d'un trauma contondant (1 patient sur 34 ou taux de survie de 2,9 %). ...

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“…6 The variables affecting the survival in penetrating cardiac injuries were investigated in many articles. [1][2][3][4][5][7][8][9][10][11][12][13][14][15] Presence of life signs was very important for predicting the survival, whereas other factors like gunshot mechanism, left ventricle injury, multiple chamber injuries, and associated other organ injuries were significant only in some series.…”

mentioning

confidence: 99%