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Retrospective study of heart injuries occurred in Manaus - Amazon
Cleinaldo de Almeida Costa1, Dario Birolini, Antônio Oliveira de Araújo
1Universidade do Estado do Amazonas, Manaus, AM, BR. cleinaldocosta@uol.com.br
Insights
Cardiac injuries, primarily stab wounds, show varying mortality rates based on lesion severity and location. Shorter operative times indicate greater severity and higher mortality in cardiac trauma patients.
Area of Science:
- Cardiovascular Surgery
- Trauma Surgery
- Emergency Medicine
Background:
- Cardiac injuries represent a significant cause of morbidity and mortality.
- Understanding treatment modalities and outcomes is crucial for improving patient survival.
Purpose of the Study:
- To evaluate treatment strategies for cardiac injuries.
- To analyze factors influencing morbidity and mortality in patients with cardiac trauma.
Main Methods:
- Retrospective study of 102 patients with cardiac injuries treated between 1998 and 2006.
- Data collected on patient demographics, injury mechanisms, surgical interventions, and outcomes.
Main Results:
- Stab wounds (81.4%) were more common than gunshot wounds (18.6%) in a predominantly male population (95.1%) with a mean age of 27.
- Cardiorrhaphy was the primary surgical intervention (98.1%). Mortality rates varied by chamber injured, with Left Atrium (LA) having the highest specific mortality (45%).
- Severe injuries (Grades IV-VI) showed increased mortality (26-100%), and shorter operative times correlated with greater injury severity and mortality.
Conclusions:
- Cardiac stab wounds are associated with lower mortality compared to other injury types.
- Higher-grade cardiac lesions (Grade IV) are linked to increased mortality.
- Shorter operative times indicate more severe injuries and poorer outcomes.
Objective:
To evaluate the forms of treatment employed to heart injuries and the main aspects related to their morbidity and mortality.
Methods:
A retrospective study of 102 patients with cardiac injuries treated in the two emergency rooms in Manaus (Dr. John Lucio Pereira Machado Emergency Hospital and August 28 County Emergency Hospital) from January 1998 to June 2006.
Results:
Of the 102 patients, 95.1% were men; mean age was 27 years; stab wounds accounted for 81.4% of cases and gunshot wounds for 18.6%; cardiorrhaphy was performed in 98.1% of cases. The heart chambers affected were: Right Ventricle (RV): 43.9% (36.2% isolated and 7.7% associated with other chambers); Left Ventricle (LV): 37.2%; Right Atrium (RA): 8.5%; and Left Atrium (LA): 10.4%; specific mortalities were of 21%, 23%, 22% and 45%, respectively. The mortality injuries to two associated chambers was 37.5%, 20% being for RA + RV, 100% for RV + LV, and zero for RV + LA. The lung accounted for 33.7% of the 89 associated lesions. Mean time of surgery and hospital stay were 121 minutes and 8.2 days, respectively. About 22.5% of patients displayed 41 complications. The mortality rate was 28.4%. Lesions grade IV and V corresponded to 55% and 41% of cases, with specific mortality of 26% and 15%, respectively. All patients with grade injuries VI died.
Conclusion:
Cardiac stab wounds were associated with lower mortality, cardiac lesions grade IV were associated with higher mortality and a shorter operative time was associated with greater severity and mortality.
