title: Penetrating cardiac wounds: predictive value of trauma indices and the necessity of terminology standardization.
abstract: The authors evaluated the usefulness of different trauma indices in the prediction of outcome following penetrating cardiac wounds. Sixty-three patients were retrospectively reviewed. Age, mechanism of injury, Physiologic Index (PI) on admission, site of injury, associated injuries, ISS, RTS, Penetrating Cardiac Trauma Index (PCTI), Penetrating Thoracic Trauma Index (PTTI), Penetrating Trauma Index (PTI), TRISS and mortality rate were reviewed. There were 34 patients with a gunshot wound (GSW) and 29 with a stab wound (SW). Shock was present on admission in 88.9 per cent. Mortality was 83 per cent for GSW, 44 per cent for SW, and 39 per cent for patients arriving the hospital with measurable blood pressure. RTS, PI, PCTI, PTTI, PTI, and ISS reached statistical significance when comparing survivors and nonsurvivors. The probability of survival (PS) based on the TRISS methodology was 37.84 +/- 5.14. The observed survival rate was 38 per cent. Fourteen patients were considered "fatal" on admission and underwent an emergency thoracothomy. Mortality rate for this selected group was 100 per cent. We conclude that physiologic impairment, shock, and GSW are variables with high significance on mortality. Trauma indices such as PI, RTS, PCTI, PTTI, PTI, and ISS are good predictors of outcome. Trauma indices are an important tool to objectively compare results among different institutions.
authors.affiliation: Department of Surgery, Santa Casa School of Medicine, Sao Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Coimbra
authors.forename: M C
authors.initials: MC
authors.lastname: Pinto
authors.forename: A
authors.initials: A
authors.lastname: Razuk
authors.forename: J R
authors.initials: JR
authors.lastname: Aguiar
authors.forename: S
authors.initials: S
authors.lastname: Rasslan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001938:Brazil / Q000453:epidemiology; D005544:Forecasting; D006335:Heart Injuries / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D009104:Multiple Trauma; D012189:Retrospective Studies; D012769:Shock / Q000175:diagnosis / Q000401:mortality; D015996:Survival Rate; D009626:Terminology as Topic; D013898:Thoracic Injuries / Q000175:diagnosis / Q000401:mortality; D013908:Thoracotomy; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000401:mortality; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000401:mortality; D014951:Wounds, Stab / Q000175:diagnosis / Q000401:mortality