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Fatal cardiac trauma in the city of Manaus, Amazonas state, Brazil
Antônio Oliveira de Araújo1, Fernando Luiz Westphal1, Luiz Carlos de Lima1
1Universidade Federal do Amazonas, Manaus, AM, Brasil.
Insights
Fatal cardiac trauma occurred in 5.98% of necropsies in Manaus, Brazil. Most deaths, primarily from gunshot wounds, happened at the trauma scene, often due to exsanguination.
Area of Science:
- Forensic Pathology
- Trauma Surgery
- Public Health
Background:
- Cardiac trauma is a significant cause of mortality.
- Understanding its epidemiology is crucial for public health interventions.
Purpose of the Study:
- To determine the incidence of fatal cardiac trauma in Manaus, Brazil.
- To analyze trauma mechanisms, hospital treatment, and associated injuries.
Main Methods:
- Retrospective, observational, cross-sectional study.
- Analysis of 2,306 necropsy reports from November 2015 to October 2016.
- Focus on cases with cardiac injury as the cause of death.
Main Results:
- Cardiac trauma accounted for 5.98% (138 cases) of deaths.
- Gunshot wounds (62.3%) and stab wounds (29.7%) were primary mechanisms.
- Exsanguination and cardiac tamponade were leading causes of death; 86.2% died at the scene.
Conclusions:
- Fatal cardiac trauma represents a notable public health issue in Manaus.
- Prompt medical intervention is critical, as delays in diagnosis contributed to mortality in some hospitalized cases.
Objective:
to determine the frequency of fatal cardiac trauma in the city of Manaus, Brazil, between November 2015 and October 2016, and to clarify the mechanisms of trauma and death, previous hospital treatment, as well as the injuries associated with cardiac trauma.
Methods:
retrospective, observational, and cross-sectional study, which reviewed the necropsy reports of individuals whose cause of death was cardiac injury.
Results:
the cardiac trauma rate was of 5.98% (138 cases) out of 2,306 necropsies performed in the study period by Instituto Médico Legal (IML) de Manaus (IML is a Brazilian institute responsible for necropsies and cadaveric reports). Males accounted for 92% of the cases. The median age was 27 years (14-83). Gunshot wounds (GSW) was the trauma mechanism in 62.3% and stab wound (SW) in 29.7%. Exsanguination was responsible for most of the deaths and cardiac tamponade was present in second place. On-site death occurred in 86.2% of the cases. The ventricles were the most common site of cardiac injury. Hemothorax was identified in 90.6% of the individuals. Only 23 patients (16.7%) were taken to the hospital (Emergency Room), but six (26.2%) were submitted only to chest drainage, not to thoracotomy. The lung was unilaterally affected in 57% of the cases and bilaterally in 43%.
Conclusion:
fatal cardiac trauma represented an index of 5.98% in the city of Manaus. Most patients die at the scene of the trauma, usually due to exsanguination caused by gunshot wound. About a quarter of patients who reached the hospital and died were not diagnosed with cardiac trauma in time.
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