A. Azim1, B. Joseph1, T. Orouji Jokar1, N. Kulvatunyou1, T. O’Keeffe1, A. Tang1, R. Latifi1, D. Green1, G. Vercruysse1, R. Friese1, P. Rhee1 1University Of Arizona,Trauma Surgery,Tucson, AZ, USA
Introduction:
Blunt cardiac injury (BCI) is uncommon. Its diagnosis, treatment and significance remain controversial. When diagnosed it is often treated with anti-arrhythmic drugs but there is little known regarding the outcome or effectiveness. The aim of this study was to assess the trend of reporting BCI using a national database.
Methods:
Retrospective 6-year (2007-2012) review of National Trauma Data Base (NTDB) of all chest trauma patients. Patients with ICD-9 Code of blunt cardiac injury (861.01) were identified. Outcome measures were mortality and admission characteristics. Regression and trend analyses were performed.
Results:
A total of 10,408 patients were included in our study. The rate of BCI was 7.45 per 10,000 patients (10,412/13,957,987) and has been decreasing over years, from 8.9 per 10,000 patients in 2007 to 6.3 per 10,000 patients in 2012 (p < 0.001). Mean age (45 ± 27 vs. 46 ± 28, p = 0.29) and male gender dominance (66.5% vs. 67.4%, p = 0.42), emergency department systolic blood pressure (117 ± 49 vs. 89 ± 39, p = 0.07), and emergency department heart rate (89 ± 39 vs. 91 ± 36, p = 0.12) did not change during the study period. 18 patients (0.2%) were diagnosed to have an associated cardiac arrhythmia. Mortality rate from cardiac contusion declined during the study period (20.7% vs. 13.8%, p < 0.0001). Mortality rate increased with increasing Chest AIS (Chest AIS-1: 4.9% vs. Chest AIS-5: 40%, p=0.001) however there were 420 patients who were diagnosed with BCI without a chest trauma (Chest AIS = 0).
Conclusion:
The incidence of blunt cardiac injury is uncommon and continues to decrease. The mortality rate has also decreased by a third. The true significance as well as relevance is yet unknown.
