Mehta Harsh, Gheith Zaid, Amin Saad, Acharya Prakash, Daon Emmanuel, Downey Peter, Hockstad Eric, Wiley Mark, Muehlebach Gregory, Zorn George, Danter Matthew, Gupta Kamal
University of Kansas School of Medicine-Kansas City, Kansas City, KS.
Department of Cardiovascular Medicine.
Kans J Med. 2024 Jun 4;17(3):45-50. doi: 10.17161/kjm.vol17.21442. eCollection 2024.
Traumatic cardiac injury (TCI) poses a significant risk of morbidity and mortality, yet there is a lack of population-based outcomes data for these patients.
The authors examined national yearly trends, demographics, and in-hospital outcomes of TCI using the National Inpatient Sample from 2007 to 2014. We focused on adult patients with a primary discharge diagnosis of TCI, categorizing them into blunt (BTCI) and penetrating (PTCI) cardiac injury.
A total of 11,510 cases of TCI were identified, with 7,155 (62.2%) classified as BTCI and 4,355 (37.8%) as PTCI. BTCI was predominantly caused by motor vehicle collisions (66.7%), while PTCI was mostly caused by piercing injuries (67.4%). The overall mortality rate was 11.3%, significantly higher in PTCI compared to BTCI (20.3% vs. 5.9%, χ(1, N = 11,185) = 94.9, p <0.001). Additionally, 21.5% required blood transfusion, 19.6% developed hemopericardium, and 15.9% suffered from respiratory failure. Procedures such as heart and pericardial repair were more common in PTCI patients. Length of hospitalization and cost of care were also significantly higher for PTCI patients, W(1, N = 11,015) = 88.9, p <0.001).
Patients with PTCI experienced higher mortality rates than those with BTCI. Within the PTCI group, young men from minority racial groups and low-income households had poorer outcomes. This highlights the need for early and specialized attention from emergency and cardiothoracic providers for patients in these demographic groups.
创伤性心脏损伤（TCI）具有较高的发病和死亡风险，但目前缺乏基于人群的此类患者的结局数据。
作者利用2007年至2014年的全国住院患者样本，研究了TCI的全国年度趋势、人口统计学特征及住院结局。我们重点关注主要出院诊断为TCI的成年患者，将其分为钝性（BTCI）和穿透性（PTCI）心脏损伤。
共识别出11510例TCI病例，其中7155例（62.2%）为BTCI，4355例（37.8%）为PTCI。BTCI主要由机动车碰撞引起（66.7%），而PTCI大多由刺伤所致（67.4%）。总体死亡率为11.3%，PTCI的死亡率显著高于BTCI（20.3%对5.9%，χ(1, N = 11185) = 94.9，p <0.001）。此外，21.5%的患者需要输血，19.6%出现心包积血，15.9%发生呼吸衰竭。心脏和心包修复等手术在PTCI患者中更为常见。PTCI患者的住院时间和护理费用也显著更高，W(1, N = 11015) = 88.9，p <0.001）。
PTCI患者的死亡率高于BTCI患者。在PTCI组中，少数种族群体和低收入家庭的年轻男性结局较差。这凸显了急诊和心胸外科医护人员对这些人群患者进行早期和专门关注的必要性。
