Management of stab wounds of the heart: analysis of 73 cases in 10 years.

Abstract

BACKGROUND:

Stab wounds of the heart still cause a significant number of traumatic deaths every year. The aim of this study was to assess the outcome of patients with cardiac stab wounds requiring emergency thoracotomy.

PATIENTS AND METHODS:

Preoperative and operative variables were reviewed for all patients treated at the Mansoura Emergency Hospital between August 1998 and July 2008.

RESULTS:

Seventy-three patients were treated for stab wounds of the heart. Of these 69 were male (94.5 %) and only 4 were female (5.5 %). Mean patient age was 28.5 +/- 5.8 years. The clinical status was stable in 22 patients (30.1 %) and unstable in 26 patients (35.6 %), while 10 patients were in shock (13.7 %), and 15 patients had suffered cardiac arrest prior to thoracotomy (20.6 %). Emergency room (ER) thoracotomy was performed in 18 patients (24.7 %) and operative room (OR) thoracotomy was carried out in 55 patients (75.3 %). The commonest location of stab wounds to the heart was the right ventricle in 28 patients (38.4 %) followed by the left ventricle in 25 patients (34.2 %). Mortality was 23.3 % (17 patients), and morbidity was 21.4 % (12 patients out of 56 surviving patients). Prognostic factors included clinical status (patients in shock or cardiac arrest had a mortality rate of 50 % and 60 %, respectively), cardiopulmonary resuscitation (CPR; mortality rate: 68.2 %) and ER thoracotomy (mortality rate: 66.7 %).

CONCLUSION:

Clinical status as shock, CPR and ER thoracotomy were prognostic of a poor outcome and associated with high mortality rates.

• Authors: N N Gwely, A Mowafy, S Khalaf, S Amer, U Hamza, M El-Saeed
• Journal: The Thoracic and cardiovascular surgeon (Thorac Cardiovasc Surg) Vol. 58 Issue 4 Pg. 210-4 (Jun 2010) ISSN: 1439-1902 [Electronic] Germany
• PMID: 20514575 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Cardiopulmonary Resuscitation
• Egypt
• Emergency Service, Hospital
• Female
• Heart Arrest (etiology, surgery)
• Heart Injuries (complications, mortality, surgery)
• Humans
• Male
• Middle Aged
• Operating Rooms
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Shock, Cardiogenic (etiology, surgery)
• Thoracotomy (adverse effects, mortality)
• Treatment Outcome
• Wounds, Stab (complications, mortality, surgery)
• Young Adult