Penetrating Heart Injuries in Hospitals with Few Facilities: Not A Moment to Waste

Document Type : Original Article

Author

Asistant Professor, Alanya Alaaddin Keykubat University, Antalya, Turkey.

10.30491/tm.2022.313969.1398

Abstract

Background: A heart injury is a genuine emergency that needs to be diagnosed and treated as soon as possible. Transport to a tertiary center with facilities such as a heart-lung pump and sternotomy can lead to loss of time. This study aimed to share the author's experiences as a solitary thoracic surgeon in a private hospital with limited facilities.
Methods:  A retrospective study was conducted in a private hospital. Eleven penetrating cardiac injuries, which were treated surgically by the same thoracic surgeon in two small hospitals from 2005 to 2015, were evaluated retrospectively. Patients' age and sex, type of injury, damage position to the heart, duration between injury and surgery, presence of additional damage, and patient survival were all recorded.
Results: The most common form of injury was defined as the sharp object injury, while the most common place was the right ventricle. In the period from injury to surgery, the additional injuries were found to be statistically significant in terms of survival ratios. The probability of patients' survival with intervention times 30, 60, and 120 minutes was 90.9, 54.5, and 27.3%, respectively.
Conclusion: Mortality in cardiac injuries can be reduced with early intervention. The risks of being transported to a developed structure and the risks of emergency surgery performed in a small facility should be well weighed. Successful surgeries may be performed even in a small, well-organized hospital.

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