title: Morphological evaluation of areas of damage in blunt cardiac injury and investigation of traffic accident research.
abstract: OBJECTIVE
  This study investigated the relation between the cause of blunt cardiac injury and areas of damage. For the purpose of injury prevention, we also examined traffic accident cases in a micro study using engineering-based medicine.
  
  
  METHODS
  Among the 2673 patients transported to our facility within the 15-month period from February 2009 to April 2010, there were 12 cases of cardiac perforation. We studied these cases anatomically to evaluate the morphology of the damaged cardiac areas. We conducted a detailed micro-study in two cases regarding the circumstances surrounding the traffic accident and the vehicular damage.
  
  
  RESULTS
  Subjects were nine men (mean age 64 years). The mean Injury Severity Score was 54.0 ± 19.6, and the probability of survival was 0.147. The actual survival rate was 16.7% (2 survivors, 10 deaths). Lesion sites in the 12 cases (21 sites in total) were the right atrium in 8 cases, superior and inferior vena cava in 5 cases, right ventricle in 4 cases, pulmonary artery and left atrium in 1 case each, and pulmonary vein in 2 cases, excluding the left ventricle and ascending aorta. In three cases, the aortic isthmus was also injured.
  
  
  CONCLUSIONS
  Blunt cardiac injury was more common on the right side chamber. The survival rate was extremely close to the calculated survival probability. Proper seatbelt usage is important for the prevention of blunt cardiac injury due to traffic accidents. Increased severity of injury may be associated with accidents involving light motor vehicles.
authors.affiliation: Department of Emergency Disaster Medicine, Saga University Hospital, Emergency Medical Center, 5-1-1 Nabeshima, Saga, 849-8501, Japan. noriyoshi.kutsukata@gmail.com
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kutsukata
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Mashiko
authors.forename: Masami
authors.initials: M
authors.lastname: Ochi
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006325:Heart Atria / Q000293:injuries / Q000473:pathology; D006335:Heart Injuries / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D006352:Heart Ventricles / Q000293:injuries / Q000473:pathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000293:injuries / Q000473:pathology; D011667:Pulmonary Veins / Q000293:injuries / Q000473:pathology; D012622:Seat Belts; D012720:Severity of Illness Index; D015996:Survival Rate; D014682:Vena Cava, Inferior / Q000293:injuries / Q000473:pathology; D014683:Vena Cava, Superior / Q000293:injuries / Q000473:pathology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000517:prevention & control