ArticleWorld journal of surgery2023
Outcomes of Cardiac Gunshot Injuries Presenting at an Urban Trauma Facility in Johannesburg, South Africa.
Article in World journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 6 citations in OpenAlex.
- Clinical presentation, acute care management and discharge information of patients with thoracic trauma in South Africa and Sweden: a prospective multicenter observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Profile and management of patients from low-middle socioeconomic status with thoracic trauma.The South African journal of physiotherapy · 2025Article
- Introduction of Laparoscopy in an Urban High-Volume Sub-Saharan Trauma Centre.World journal of surgery · 2023Review
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGunshot wounds to the heart are regarded as one of the most lethal penetrating injuries. There has been an increase in gunshot wounds to the chest in our institution in recent years. Injuries to the heart caused by gunshot wounds can be challenging, with patients arriving in hospital in different physiological states. We report our trauma unit's experience with civilian gunshot wounds to the heart.
methodsA retrospective review from January 2005 till December 2018 of those 18 years of age and above who presented to our hospital with penetrating cardiac injuries over eight years was done. Those who presented with a carotid pulse and a cardiac rhythm were included in the study. Blood pressure of less than 90 mmHg was considered as haemodynamic instability. Demographics, physiological parameters, injuries sustained, preferred surgical access to the chest, and type of surgery were analysed. The complications during their hospital stay and outpatient clinic were documented. The incidences of in-hospital mortality were also noted. Descriptive statistics with STATA version 15 were conducted. A p-value of < 0.05 was considered statistically significant.
resultsA total of 37 patients were enroled in the study; four were excluded for incomplete data. All presented directly from the scene, with a median age of 30 (IQR 24-36). Haemodynamic instability was in 64% of the cases. The most common injured chamber was the right ventricle (75.7%). There were only two complications recorded; local wound sepsis and empyema. All survivors received a post-surgical echocardiogram. The overall survival rate was 18.9% (n = 7). Of the ten that required emergency room thoracotomy, only one survived to discharge.
conclusionGunshot wounds to the heart have a mortality rate greater than 80% in those arriving alive. Only one in ten of those who meet the strict criteria for emergency room thoracotomy survive hospitalisation. The local complication rate was low.
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