BLUNT CARDIAC RUPTURE - THE EMANUEL-TRAUMA-CENTER EXPERIENCE

Objective: To analyze the factors affecting outcome in patients with b lunt cardiac rupture, including anatomical cardiac injury, associated injury, clinical presentation, age, mechanism of injury, diagnostic me thod, surgical intervention, and presence of vital signs in the field and on arrival. Design: Retrospective review. Setting: A community-bas ed level I trauma center. Patients: A consecutive series of 27 patient s seen between 1984 and 1993. Main Outcome Measurer Survival with retu rn to preinjury activity. Results: Eleven patients (41%) survived resu scitation, surgery, and initial hospital care. Survivors had a lower m ean Injury Severity Score (38) than nonsurvivors (62) (P<.05). Three ( 33%) of nine patients who arrived with no blood pressure or viable ele ctrical heart rhythm survived. No patient survived rupture of two card iac chambers. Conclusions: Patients with blunt cardiac rupture who pre sent with cardiac arrest can survive. Nonsurvivors tend to have more a ssociated injuries, as indicated by higher Injury Severity Scores. Our institution's overall survival rate of 41% (11/27) compares favorably with rates at other trauma centers.