PENETRATING CARDIAC INJURIES - 20-YEAR EXPERIENCE

  • 1 June 1987
    • journal article
    • research article
    • Vol. 53  (6) , 310-317
Abstract
Analysis of 228 patients who sustained penetrating cardiac injuries (1963-1983) reveals that 1) among patients who arrived with vital signs, survival was 73 per cents as opposed to 29 per cent of patients who arrived in extremis; and 2) delay in thoracotomy contributed to an increased mortality among patients in profound shock who failed to respond promptly to volume expansion and agonal patients who were transported to the operating room for thoracotomy. An increasing incidence of gunshot wounds and a greater frequency of patients presenting in extremis was noted in the latter years of the study as compared with the earlier period. Our data indicate that there is an increasing need for emergency room thoracotomy in the management of cardiac injuries. Urban trauma centers should be equipped for major procedures in the emergency room and, ideally, should have operating rooms in this area.