Management of Cardiac Injuries: A Single Center 10 Year Experience
Reginald Alouidor, MD FACS Elizabeth Santone, MD Francesca Izzo, MD Aixa Perez-Caraballo, MS MPH Nicole Corriveau Kristina Kramer, MD Edward Kelly, MD FACS Tyler Putnam, MD FACS Eleanor Winston, MD FACS Gabriel Ryb, MD FACS
Baystate Medical Center, University of Massachusetts Medical School-Baystate Health, Springfield, MA.
Background: Traumatic cardiac injuries challenge even experienced trauma surgeons. Cardiac Surgery is often consulted, but the benefit is unclear. We compare outcomes when managed by Trauma Surgery alone versus with Cardiac Surgery.
Methods: A retrospective review of cardiac injuries from an academic level 1 trauma center between January 2009 and December 2019.
Results: 65 patients were identified; 38 (58%) penetrating and 27 (42%) blunt injuries. 25 penetrating injuries survived to the operating room, Cardiac Surgery was consulted on 5 (13%), 2 patients required cardiopulmonary bypass. None of the penetrating injuries who arrived in cardiac arrest survived. Survival for Trauma Surgery alone was 42%, survival with cardiac surgery assistance was 60% (p=0.46). When resuscitative thoracotomy deaths were excluded, survival with Trauma Surgery alone was 67%, compared to 75% with Cardiac Surgery involvement (p=0.74). Of the 27 blunt injuries; 15 required immediate surgery. Cardiac Surgery was consulted in 6, 3 were managed by Cardiac Surgery alone, 1 by Thoracic Surgery. Again, none of the patients who arrived in cardiac arrest survived. Of the patients who survived to the operating room, 54% survived to discharge. Survival for Trauma Surgery alone was 33%, survival with Cardiac Surgery involvement was 56% (p=0.4).
Conclusion: Cardiac Surgery involvement did not statistically affect survival in traumatic cardiac injury patients treated with operative intervention. Overall outcomes were better in patients who presented with intact vitals.
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