title: Traumatic cardiac injury: Experience from a level-1 trauma centre.
abstract: OBJECTIVE
  Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI.
  
  
  METHODS
  Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15.
  
  
  RESULTS
  Out of 21 cases of TCI, 6 (28.6%) had isolated and 15 (71.4%) had associated injuries. Ratio be- tween blunt and penetrating injuries was 2:1 with male preponderance. Mean ISS was 31.95. Thirteen patients (62%) presented with features suggestive of shock. Cardiac tamponade was present in 12 (57%) cases and pericardiocentesis was done in only 6 cases of them. Overall 19 patients underwent surgery. Perioperatively 8 (38.1%) patients developed cardiac arrest and 7 developed cardiac arrhythmia. Overall survival rate was 71.4%. Mortality was related to cardiac arrest (p = 0.014), arrhythmia (p = 0.014), and hemorrhagic shock (p =0.04). The diagnostic accuracy of focused assessment by sonography in trauma (FAST) was 95.24%.
  
  
  CONCLUSIONS
  High index of clinical suspicion based on the mechanism of injury, meticulous examination by FAST and early intervention could improve the overall outcome.
authors.affiliation: Division of Trauma Surgery & Critical Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Biplab
authors.initials: B
authors.lastname: Mishra
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Sushma
authors.initials: S
authors.lastname: Sagar
authors.forename: Maneesh
authors.initials: M
authors.lastname: Singhal
authors.forename: Subodh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed