title: Blunt Traumatic Cardiac Rupture: Single-Institution Experiences over 14 Years.
abstract: BACKGROUND
  Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture.
  
  
  METHODS
  This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities.
  
  
  RESULTS
  Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p= 0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived.
  
  
  CONCLUSIONS
  We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Yun
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine.
authors.forename: Joung Hun
authors.initials: JH
authors.lastname: Byun
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine.
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine.
authors.forename: Hyun Oh
authors.initials: HO
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine.
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Hwang
authors.affiliation: Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine.
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Kim
keywords: Cardiac tamponade; Rupture; Trauma