Mortalidad por trauma cardiaco penetrante en bogota, colombia: análisis de factores asociados

Abstract

Background: Most studies reported in literature of patients with heart injuries are merely descriptive and not large enough to obtain statistical conclusions. The prevalence of attacks on civilians in some sectors of Colombian cities is high. Materials and methods: To study the probability of mortality in patients admitted to surgical wards with heart wounds, a case-control study nested in the historical cohort of 240 patients admitted to surgical wards Kennedy Western Hospital with a diagnosis of penetrating wound of the heart, between January 1999 and October 2009 was done.Results: Overall mortality was 15% (n = 36): 52.9% (9/17) for patients with gunshot wounds and 12.1% (27/223) for patients with stab wounds. OR values established that the fi rearm injuries, hemodynamic status, degree of injury, concomitant injuries in chest and / or abdomen and requiring a resuscitative thoracotomy were associated with increased likelihood of death. The results of the multivariate analysis show that the only factors that are associated with mortality are the gunshot injury (OR 7.22, 95% CI 4.6-112.9), and hemodynamic status (fatal: OR 11.4, 95 1.6-82.0%, agonizing: 12.8, CI 3.4-48.5, deep shock: 10.35, CI 2.9-36.4). Conclusion: Penetrating cardiac trauma in our study was mainly caused by stab weapon wounds with a survival similar to other studies with this predominant mechanism. Our results are consistent with the parameters of mortality risk previously proposed in the literature and in our patients the hemodynamic status on admission to surgery and injuries caused by fi rearms, proved to be signifi cant predictors of mortality. The presence of cardiac tamponade had no protective effect. Keywords: Penetrating cardiac trauma, Stab wound, Trauma in Colombia. How to cite this article: Isaza-Restrepo A, Bolívar-Sáenz DJ, Tarazona M, Jiménez MF, Laverde FAG. Mortalidad Por Trauma Cardiaco Penetrante en Bogota, Colombia: Análisis de Factores Asociados. Panam J Trauma Critical Care Emerg Surg 2012;1(2):76-84. Source of support: