Penetrating heart injuries in hospitals with few facilities: Not a moment to waste

Abstract

Background: Penetrating 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 in a private hospital with limited facilities.

Methods: A retrospective study was conducted at a private hospital. Eleven penetrating cardiac injuries, which were treated surgically by the at two small hospitals from 2005 to 2015, were evaluated retrospectively. Patients' age and sex, type of injury, damage site at 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 sharp object injury, while the most common site was the right ventricle. 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 at 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 an advanced hospital and the risk of emergency surgery performed in a small less equips facility should be well weighed. Successful surgeries may be performed even in a small, well-organized hospital.