Blunt cardiac rupture: A 5-year NTDB analysis

Pedro G R Teixeira, Kenji Inaba, Didem Oncel, Joseph Dubose, Linda Chan, Peter Rhee, Ali Salim, Timothy Browder, Carlos Brown, Demetrios Demetriades

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objective: Because of its rarity and high rate of mortality, traumatic blunt cardiac rupture (BCR) has been poorly studied. The objective of this study was to use the National Trauma Data Bank to review the epidemiology and outcomes associated with traumatic BCR. Methods: After approved by the institutional review board, the National Trauma Data Bank (version 5.0) was queried for all BCR occurring between 2000 and 2005. Demographics, clinical injury data, interventions, and outcomes were abstracted for each patient. Statistical analysis was performed using an unpaired Student's t test or Mann-Whitney U test to compare means and X2 analysis to compare proportions. Stepwise logistic regression analysis was performed to identify independent predictors of inhospital mortality. Results: Of 811,531 blunt trauma patients, 366 (0.045%) had a BCR of which 334 were available for analysis, with the mean age of 45 years, 65% were men, and their mean Injury Severity Score was 58 ± 19. The most common mechanism of injury was motor vehicle collision (73%), followed by pedestrian struck by auto (16%), and falls from height (8%). Twenty-one patients (6%) died on arrival and 140 (42%) died in the emergency room. The overall mortality for patients arriving alive to hospital was 89%. Of the patients surviving to operation, 42% survived >24 hours of which 87% were discharged. Survivors were significantly younger (39 vs. 46 years, p = 0.04), had a lower Injury Severity Score (47 vs. 56, p = 0.02), higher Glasgow Coma Scale (10 vs. 6, p < 0.001), and were more likely to present with an systolic blood pressure ≥90 mm Hg (p = 0.01). Nevertheless, none of these factors was found to be an independent risk factor for mortality. Conclusion: BCR is an exceedingly rare injury, occurring in 1 of 2400 blunt trauma patients. In patients arriving alive to hospital, traumatic BCR is associated with a high mortality rate, however, is not uniformly fatal.

Original languageEnglish (US)
Pages (from-to)788-791
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume67
Issue number4
DOIs
StatePublished - Oct 2009

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Heart Rupture
Heart Injuries
Wounds and Injuries
Injury Severity Score
Mortality
Databases
Blood Pressure
Glasgow Coma Scale
Research Ethics Committees
Motor Vehicles
Nonparametric Statistics
Hospital Mortality
Survivors
Hospital Emergency Service
Epidemiology
Logistic Models
Regression Analysis
Demography
Students

Keywords

  • Blunt cardiac injury
  • Cardiac rupture
  • Outcomes
  • Trauma
  • Wounds and injuries

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Teixeira, P. G. R., Inaba, K., Oncel, D., Dubose, J., Chan, L., Rhee, P., ... Demetriades, D. (2009). Blunt cardiac rupture: A 5-year NTDB analysis. Journal of Trauma - Injury, Infection and Critical Care, 67(4), 788-791. https://doi.org/10.1097/TA.0b013e3181825bd8

Blunt cardiac rupture : A 5-year NTDB analysis. / Teixeira, Pedro G R; Inaba, Kenji; Oncel, Didem; Dubose, Joseph; Chan, Linda; Rhee, Peter; Salim, Ali; Browder, Timothy; Brown, Carlos; Demetriades, Demetrios.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 67, No. 4, 10.2009, p. 788-791.

Research output: Contribution to journalArticle

Teixeira, PGR, Inaba, K, Oncel, D, Dubose, J, Chan, L, Rhee, P, Salim, A, Browder, T, Brown, C & Demetriades, D 2009, 'Blunt cardiac rupture: A 5-year NTDB analysis', Journal of Trauma - Injury, Infection and Critical Care, vol. 67, no. 4, pp. 788-791. https://doi.org/10.1097/TA.0b013e3181825bd8
Teixeira, Pedro G R ; Inaba, Kenji ; Oncel, Didem ; Dubose, Joseph ; Chan, Linda ; Rhee, Peter ; Salim, Ali ; Browder, Timothy ; Brown, Carlos ; Demetriades, Demetrios. / Blunt cardiac rupture : A 5-year NTDB analysis. In: Journal of Trauma - Injury, Infection and Critical Care. 2009 ; Vol. 67, No. 4. pp. 788-791.
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