title: Penetrating cardiac trauma in adolescents: a rare injury with excessive mortality.
abstract: BACKGROUND
  Penetrating cardiac injuries in pediatric patients are rarely encountered. Likewise, the in-hospital outcome measures following these injuries are poorly described.
  
  
  METHODS
  All pediatric patients (<18years) sustaining penetrating cardiac injuries between 1/2000 and 12/2010 were retrospectively identified using the trauma registry of an urban level I trauma center. Demographic and admission variables, operative findings, and hospital course were extracted. Outpatient follow-up data were obtained through chart reviews and cardiac-specific imaging studies.
  
  
  RESULTS
  During the 11-year study period, 32 of the 4569 pediatric trauma admissions (0.7%) sustained penetrating cardiac injuries. All patients were male and the majority suffered stab wounds (81.2%). The mean systolic blood pressure on admission was 28.8±52.9mmHg and the mean ISS was 46.9±27.7. Cardiac chambers involved were the right ventricle (46.9%), the left ventricle (43.8%), and the right atrium (18.8%). Overall, 9 patients (28.1%) survived to hospital discharge. Outpatient follow-up echocardiography was available for 4 patients (44.4%). An abnormal echocardiography result was found in 1 patient, demonstrating hypokinesia and tricuspid regurgitation.
  
  
  CONCLUSIONS
  Penetrating cardiac trauma is a rare injury in the pediatric population. Cardiac chambers predominantly involved are the right and left ventricles. This injury is associated with a low in-hospital survival (<30%).
authors.affiliation: Division of Acute Care Surgery (Trauma, Emergency Surgery and Surgical Critical Care), Department of Surgery, Keck School of Medicine, Los Angeles County+University of Southern California Medical Center, Los Angeles, CA 90033, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lustenberger
authors.forename: Peep
authors.initials: P
authors.lastname: Talving
authors.forename: Lydia
authors.initials: L
authors.lastname: Lam
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Shahin
authors.initials: S
authors.lastname: Mohseni
authors.forename: Jennifer Ann
authors.initials: JA
authors.lastname: Smith
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D000293:Adolescent; D006335:Heart Injuries / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D014950:Wounds, Penetrating / Q000401:mortality* / Q000601:surgery*