Evaluation of penetrating cardiac stab wounds

Abstract

Background: The purpose of this study was to identify factors associated with unfavourable outcome following stab wounds to the heart in order to improve selection of patients who may benefit from resuscitative effort. Methods: From February to March, variables were collected from medical records of patients sustaining cardiac trauma. The inclusion criterion was the presence of a penetrating cardiac injury confirmed intraoperatively. Results: Ninety-eight patients were admitted with penetrating cardiac injury. The mortality rate was 60 %. Fifty-seven patients had unrecordable blood pressure at admission and emergency department thoracotomy was done in twelve patients. The AAST-OIS score was higher in non survivors group (4,21 vs 4,49). Multivariate analysis identified tamponade, associated injuries, right ventricular laceration as the most predictive variables for mortality. Discussion: Stab wounds should be separated from gunshots wounds as the former mechanism has different pathophysiological issue. Patients arriving without signs of life may benefit from aggressive resuscitative efforts depending on transport time. Conclusion: Penetrating cardiac injuries are highly lethal condition. Cardiac tamponade, right ventricle lacerations and associated extra-cardiac injuries are independent risk factors of death.