Background This study was a clinicoforensic analysis of the prevalence
and outcome of traumatic cardiac injuries in Durban. Methods Between
1990 and 1992, 1198 patients sustained cardiac trauma. Seventy (6 per
cent) reached hospital alive and 1128 (94 per cent) were taken directl
y to the mortuary. Seven hundred victims had suffered stab wounds, 494
gunshot wounds and four blast injuries. Gunshot injuries increased fr
om 34 per cent in 1990 to 50 per cent in 1992. The mean(s.d.) age was
30.5(5.4)years and the majority (91 per cent) were men. Results Thirty
-five (50 per cent) of those who reached hospital alive died, includin
g all four gunshot victims. Significant factors associated with surviv
al were isolated injury, the presence of cardiac tamponade (univariate
and multivariate analysis), right ventricular injury, single cardiac
chamber injury and absence of pleural breach (univariate analysis alon
e). Delay in operative intervention was associated with a higher morta
lity rate. When analysing the patients who did not reach hospital aliv
e, 202 (18 per cent) with tamponade due to an isolated stab wound were
identified as a subset who might have been saved with prompt treatmen
t. Conclusion An increasing number of gunshot injuries in combination
with delays in reaching hospital and in receiving treatment accounted
for the high mortality rate in this unselected series.