Penetrating cardiac injuries: a population-based study.
BACKGROUND
Wide variances exist in reports of survival rates after penetrating cardiac injuries because most are hospital-based reports and thus are affected by the local trauma system. The objective of this study was to report population-based, as well as hospital-based, survival rates after penetrating cardiac injury.


METHODS
Retrospective cohort analysis was performed during a 7-year period of 20,181 consecutive trauma admissions to a regional Level I trauma center and 6,492 medical examiner's reports. A meta-analysis was performed comparing survival rates with available population-based reports.


RESULTS
There were 212 penetrating cardiac injuries identified, for an incidence of approximately 1 per 100,000 man years and 1 per 210 admissions. The overall survival rate was 19.3% (41 of 212) for the population studied, with survival rates of 9.7% (12 of 123) for gunshot wounds and 32.6% (29 of 89) for stab wounds. Ninety-six of the 212 patients were transported to the trauma center for treatment, resulting in an overall hospital survival rate of 42.7% (41 of 96), with a hospital survival rate of 29.3% (12 of 41) for gunshot wounds and 52.7% (29 of 55) for stab wounds.


CONCLUSIONS
Review of population-based studies indicates that there has been only a minor improvement in the survival rates for the treatment of penetrating cardiac injuries.
Harborview Injury Prevention Center, Seattle, WA, USA.
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PM
Rhee
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Foy
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Kaufmann
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Areola
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Boyle
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Maier
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Jurkovich
D000046:Academic Medical Centers; D000328:Adult; D002423:Cause of Death / Q000639:trends; D005260:Female; D006335:Heart Injuries / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014193:Trauma Centers; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000209:etiology / Q000401:mortality* / Q000601:surgery*