Introduction.

The management of penetrating cardiac injury is challenging since it requires rapid surgical management to avoid a fatal outcome. Multiple prognostic factors have been described, however, the relationship between the time of arrival to the operating room and the use of pledgets with mortality has not been documented.

Methods.

A cross-sectional retrospective observational study was conducted from 2011 to 2018 in a university hospital in the city of Medellín. Records of patients with confirmed penetrating cardiac injury were evaluated, and univariate, bivariate, and multivariate analyzes were performed, as well as survival curves.

Results.

Unstable patients or patients with cardiac tamponade who arrive to the operating room after 4 minutes after being admitted to the emergency room are four times more likely to die than those who arrive to the operating room earlier (RR 4.1 95% CI 1.43-12.07). The use of pledgets in the repair of the cardiac wound corresponds to a protective factor for patients, with an adjusted OR of 2.5 (95% CI 1.124-5.641). The type of trauma, intraoperative arrhythmia and the shock index on admission were also prognostic factors.

Discussion.

The effect of the time of arrival to the operating room on mortality is documented, which will allow in the future to generate changes in the management of these patients based on these times. The evidence found suggests better outcomes with the routine use of pledgets.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )