title: Outcome of penetrating cardiac injuries in southern Iran, Shiraz.
abstract: OBJECTIVE
  Cardiac injuries are one of the most challenging injuries in the field of trauma surgery. Their management often requires immediate surgical intervention, excellent surgical technique and the ability to provide excellent postoperative critical care to patients. The aim of this study was to evaluate the outcome and survival rate of patients with penetrating cardiac injury in southern Iran, Shiraz.
  
  
  METHODS
  From January 2001 to June 2007, medical records of all patients suffering from penetrating cardiac injuries were reviewed and their outcomes were investigated. The inclusion criterion was the presence of a confirmed penetrating cardiac injury intraoperatively or by autopsy. Patients with blunt cardiac injuries were excluded from the study.
  
  
  RESULTS
  The study consisted of 37 patients, including 1 gunshot wound (2.7%), 35 stab wounds (94.6%) and 1 (2.7%) shotgun wound. The overall survival rate was 76% (28 in 37) and that in stab wound patients was 80%. The collected data of 9 expired patients revealed 11% death on arrival, 67% hypotensive, and 22% normotensive considering physiologic presentation. Paired sample test showed significant correlation between mortality and electrocardiographic changes, amount of retained blood in pericardium, clinical stage and physiologic condition at presentation, as well as associated injury type (gunshot more than stab wound).
  
  
  CONCLUSIONS
  Our results show that injury mechanism and initial cardiac rhythm are significant predictors of outcomes in patients with penetrating cardiac injuries. Besides, gunshot injury and exsanguination are the most important predictive variables of mortality.
authors.affiliation: Cardiac Surgery Department, Shiraz University of Medical Sciences, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Janati
authors.forename: Shahram
authors.initials: S
authors.lastname: Bolandparvaz
authors.forename: Shirvan
authors.initials: S
authors.lastname: Salaminia
authors.forename: Hamed-Ghoddusi
authors.initials: HG
authors.lastname: Johari
authors.forename: Babak
authors.initials: B
authors.lastname: Sabet
authors.forename: Javad
authors.initials: J
authors.lastname: Kojuri
mesh_terms: D000293:Adolescent; D000328:Adult; D004562:Electrocardiography; D005260:Female; D006335:Heart Injuries / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014950:Wounds, Penetrating / Q000401:mortality* / Q000503:physiopathology