[Penetrating cardiac trauma]

The author reviewed the clinical records of 40 patients with the diagnosis of penetrating cardiac trauma operated on in a period of 38 months in order to confirm the prognostic value of trauma indexes: Physiologic Index, Revised Trauma Scale and Index of Penetrating Cardiac Trauma. Thirty-eight patients were men and two were women with an average age of 26.8 years. Thirty-one patients suffered knife wounds and nine were wounded by bullets. The 15 unstable patients (systolic Blood Pressure 80 mmHg after infusion of crystalloid solutions) were submitted to thoracotomy. The 25 stable patients underwent the performance of a pericardial (subxiphoid) window for diagnosis, followed by sternotomy if the result was positive. There were 5 deaths all of which occurred in the operating room due to exsanguination. In all these cases Revised Trauma Scale was less than 3 and the Physiologic Index was grade III in four and grade II in one patient. Our results indicate that the Revised Trauma Scale and the Physiologic Index are good prognostic indicators of survival and that patients with Physiologic Index grade I and II have good probabilities for survival if they are operated on promptly.