Effect of early surgical intervention on the outcome of cases with penetrating cardiac trauma

Abstract

Background Early management of penetrating cardiac injury is crucial to improve the outcome of trauma cases. Aim To assess the effect of early surgical intervention in cases with penetrating cardiac injury on patients’ outcomes. Methods This observational study reviewed the hospital files of cases that presented to the emergency departments of two tertiary centers following chest trauma. The patients were categorized according to the time duration from presentation to surgical intervention into early intervention (within less than 30 min) and late intervention groups (after more than 30 min). Results The study included 29 cases. Early intervention occurred in 18 cases, whereas 11 cases had the intervention after 30 min. Early intervention was significantly associated with lowering the median ICU stay (P=0.009), the median duration of mechanical ventilation (P=0.008), and the rate of complications (P=0.048) as well as an excellent rating of satisfaction (P<0.001). On multivariate analysis, early intervention was associated significantly with lower ICU stay [odds ratio (OR): 0.063, 95% confidence interval (CI): 0.007–0.546, P=0.012] and hospital stays (OR: 0.184, 95% CI: 0.040–0.844, P=0.029) but did not significantly reduce the probability of complications (OR: 0.097, 95% CI: 0.009–1.022, P=0.052). Conclusions Early surgical intervention positively affects the patient’s outcome after penetrating cardiac injuries. It reduces ICU and hospital stays and may decrease the rate of complications. Every effort should be directed toward reducing the time lag from emergency department to the operating theater.