Resumo

VILLEGAS LANAU, María Isabel et al. Penetrating cardiac trauma: Prognostic factors. rev. colomb. cir. [online]. 2007, vol.22, n.3, pp.148-156. ISSN 2011-7582.

Background: The prognosis of patients with cardiac trauma depends on the type and magnitude of their lesions, the prehospital support received and the clinical state at admission to the emergency unit. Knowledge of these factors allows treatment modifications, leading to an improved prognosis. Methods: Retrospective cohort study. Setting: Universidad de Antioquia and San Vicente de Paúl University Hospital, Medellín, Colombia. 204 patients suffering from cardiac trauma were studied between January 1st 1997 and December 31st 1999. Primary outcome was either intra- or postoperative death; secondary outcome was postoperative complications. Results: 90% were men. 10% of the patients died; the following factors increased the risk of death: lesions by firearm; lesions of two or more cardiac chambers, and two or more cardiac lesions; risk also becames, higher as scores in PI, PTTI and PCTI indexes increase. Logistic regression analysis revealed that intraoperative shock and arrhythmia were factors independently associated with mortality (OR: 19.6 and 22.3 respectively). Forty five patients (22%) suffered postoperative complications but no association was found between them and the factors studied. Conclusion: The use of trauma indexes is important when comparing results obtained at different institutions; the association between mortality and intraoperative shock and/or arrhythmia, should lead to more aggressive reanimation attempts in order to reduce the former.

Palavras-chave : heart; wounds and injuries; prognosis.

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