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Cardiac trauma: has survival improved? A university hospital experience in Bangkok, Thailand

Kritaya Kritayakirana1, Sukanya Sriussadaporn, Rattaplee Pak-Art

  • 1Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Kritaya.k@chula.ac.th

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|August 14, 2013
PubMed

Insights

Prompt management of cardiac trauma significantly improved survival rates, dropping mortality from 26% to 4%. A high index of suspicion is crucial for diagnosing chest injuries and ensuring timely treatment.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Cardiac trauma, if not promptly diagnosed and treated, is often fatal.
  • Established diagnostic and treatment protocols have been consistently applied over 16 years.
  • Survival rates in patients with cardiac trauma have shown improvement between study cohorts.

Purpose of the Study:

  • To investigate factors influencing survival in patients diagnosed with cardiac trauma.
  • To evaluate the effectiveness of a consistent management policy over an extended period.

Main Methods:

  • Retrospective chart review of patients with cardiac trauma from September 1994 to April 2010.
  • Utilized emergency room thoracotomy for patients in extremis with suspected cardiac trauma.
  • Employed Focused Assessment with Sonography for Trauma (FAST), transthoracic echocardiography, and intraoperative subxiphoid window/median sternotomy for diagnosis.

Main Results:

  • A total of 44 patients with cardiac trauma were identified, with an overall mortality rate of 13.6%.
  • The right ventricle was the most frequently injured chamber (44%), followed by the right atrium (23%) and left ventricle (20%).
  • 30% of patients underwent emergency room thoracotomy, and 38% had associated injuries.

Conclusions:

  • A high index of suspicion and prompt management are essential for patients with chest injuries indicative of cardiac trauma.
  • The study observed a reduction in mortality rate from 26% to 4%, although this change was not statistically significant.
  • Consistent adherence to diagnostic and treatment policies over 16 years contributed to improved outcomes in cardiac trauma management.
Abstract

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