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Penetrating Cardiac Injuries: A Population-Based Study

Rhee, Peter M. MD, MPH; Foy, Hugh MD; Kaufmann, Christoph MD, MPH; Areola, Carlos MD; Boyle, Edward MD; Maier, Ronald V. MD; Jurkovich, Gregory MD

The Journal of Trauma: Injury, Infection, and Critical Care: August 1998 - Volume 45 - Issue 2 - p 366-370
Articles: Presented At The 11Th Annual Meeting Of The Eastern Association For The Surgery Of Trauma, January 14-17, 1998, Sanibel, Florida

Background Wide variances exist in reports of survival rates after penetrating cardiac injuries because most are hospital-based reports and thus are affected by the local trauma system. The objective of this study was to report population-based, as well as hospital-based, survival rates after penetrating cardiac injury.

Methods Retrospective cohort analysis was performed during a 7-year period of 20,181 consecutive trauma admissions to a regional Level I trauma center and 6,492 medical examiner's reports. A meta-analysis was performed comparing survival rates with available population-based reports.

Results There were 212 penetrating cardiac injuries identified, for an incidence of approximately 1 per 100,000 man years and 1 per 210 admissions. The overall survival rate was 19.3% (41 of 212) for the population studied, with survival rates of 9.7% (12 of 123) for gunshot wounds and 32.6% (29 of 89) for stab wounds. Ninety-six of the 212 patients were transported to the trauma center for treatment, resulting in an overall hospital survival rate of 42.7% (41 of 96), with a hospital survival rate of 29.3% (12 of 41) for gunshot wounds and 52.7% (29 of 55) for stab wounds.

Conclusion Review of population-based studies indicates that there has been only a minor improvement in the survival rates for the treatment of penetrating cardiac injuries.

From the Harborview Injury Prevention Center (P.M.R., H.F., C.A., E.B., R.V.M., G.J.), Scattle, Washington; the Department of Surgery (P.M.R., H.F., C.A., E.B., R.V.M., G.J.), Harborview Medical Center, University of Washington, Seattle, Washington; and the Department of Surgery (P.M.R., C.K.), Uniformed Services University of the Health Sciences, Bethesda, Maryland.

The research for this study was supported by grant R49/CCR002570 from the Center for Disease Control, Harborview Injury Prevention and Research Center.

The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences, the Department of the Navy, or the Department of Defense.

Address for reprints: Peter M. Rhee, MD, MPH, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.

© Williams & Wilkins 1998. All Rights Reserved.