Outcomes of the cardiac injuries and penetrating wounds treatment via sternotomy at Dong Nai Provincial Hospital

Abstract

Background: Cardiac injuries from penetrating wounds or blunt trauma are severe surgical emergencies with high mortality rates, ranging from 6% in chest wounds to 7-76% in blunt chest trauma, as reported in the literature. This study aims to evaluate the effectiveness of surgical treatment for cardiac injuries at provincial hospitals in Dong Nai, a region characterized by a large population and numerous industrial zones.

Materials and Methods: A retrospective descriptive case series study was conducted on patients undergoing surgical treatment for cardiac injuries via sternotomy at Dong Nai General Hospital and Thong Nhat General Hospital from February 2024 to October 2024. Data were collected from medical records, including demographics, injury mechanisms, surgical timing, complications, and mid-term outcomes.

Results: Among 37 patients, 65% presented with penetrating cardiac wounds, with a median age of 29.7 years; 86% were male, and 62% were manual laborers. The median time from admission to surgery was 45 minutes, with a mean surgical duration of 113.24 ± 28.9 minutes. Blunt trauma accounted for 40.54% of cases. Postoperative complications occurred in 24.3%, with a mortality rate of 13.5%. Mid-term complications were observed in 18.75%, mostly mild and self-limiting within 3 months. Coma on admission (p=0.014; OR=17.33) and associated injuries (p=0.021; OR=14.2) were significantly associated with mortality.

Conclusions: Surgical outcomes for cardiac injuries in Dong Nai are comparable to national and international studies. Coma on admission and associated injuries are key prognostic factors for mortality, highlighting the need for improved emergency response and multidisciplinary coordination at provincial facilities.