Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area

Montenegro Muñoz, Jorge Hernan; Ruiz, Francisco; Dussan, Oscar; Puyana, Juan Carlos; RUBIANO ESCOBAR, ANDRES MARIANO

doi:10.14744/tjtes.2020.70503

Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area

Jorge Hernan Montenegro MUNOZ, (Meditech Foundation, Clinical Research Group, Neiva, Colombia)

Oscar DUSSAN, (South Colombian University, Department of General Surgery, Neiva, Colombia)

Francisco RUIZ, (South Colombian University, Hernando Moncaleano Hospital, Department of General Surgery, Neiva, Colombia)

Andres M. RUBİANO, (El Bosque University, Neurosciences Institute, Meditech Foundation, Bogota, Colombia)

Juan C. PUYANA (University of Pittsburgh, Department of Surgery, Division of Trauma, Pittsburgh, USA)

Ulusal Travma ve Acil Cerrahi Dergisi

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Yıl: 2020 Cilt: 26 Sayı: 5 Sayfa Aralığı: 693 - 698 Metin Dili: İngilizce DOI: 10.14744/tjtes.2020.70503 İndeks Tarihi: 03-11-2020

Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area

Öz:

BACKGROUND: Stab wounds (SW) to the thorax raises suspicion for cardiac injuries; however, the topographic description isvariable. The present study aims to evaluate different topographical descriptions within the thorax and establish their diagnostic valuein penetrating cardiac trauma by SW.METHODS: Medical records of all patients admitted to our center with thoracic SW from January 2013 to June 2016 were includedin this study. Diagnostic value potential was measured using different areas of the thorax described in the literature.RESULTS: In this study, we analyzed 306 cases. Thirty-eight (12.4%) patients had a cardiac injury managed surgically. Death by cardiacinjury occurred in seven (18.4%) patients. The cardiac area defined between the right mid-clavicle line until the left anterior axillaryline, and between 2nd and 6th intercostal spaces was the more accurate. It has sensitivity of 97.3%, specificity 72%, positive predictivevalue 33%, negative predictive value 99.4% and accuracy 75.1% for penetrating cardiac trauma. ROC was 0.894 IC 95% (0.760–0.901).CONCLUSION: Among the thoracic areas, topographical limits between the right mid-clavicle line and the left anterior axillary line, andbetween 2nd and 6th intercostal spaces are the more accurate and are highly indicative of cardiac injury in patients with SW to the thorax.

Anahtar Kelime:

Kesici-delici alet yaralanmalarında penetran kardiyak travma: Kardiyak bölgenin doğru tanısına ilişkin bir çalışma

Öz:

AMAÇ: Torakstaki kesici ve delici alet yaralanmaları (SW) kardiyak yaralanma şüphesini akla getirmekle beraber bunlara ilişkin tomografik açıklamalar değişkenlik gösterir. Bu çalışma, toraks içindeki farklı tomografik tanımlamaları değerlendirilmesi ve SW’nin penetran kardiyak travmasındaki tanı değerlerinin saptanması amaçlanmaktadır. GEREÇ VE YÖNTEM: Ocak 2013 - Haziran 2016 tarihleri arasında merkezimize torasik SW ile başvuran tüm hastaların tıbbi kayıtları bu çalışmaya alındı. Bunların tanı değeri potansiyelleri literatürde açıklanan farklı toraks alanları kullanılarak ölçüldü. BULGULAR: Üç yüz altı olgu analiz edildi. Otuz sekiz (%12.4) hastada cerrahi olarak yönetilen kalp yaralanması vardı. Kardiyak yaralanma nedeniyle ölüm 7 (%18.4) hastada meydana geldi. Sağ ön klavikula çizgisi ile sol ön aksiller çizgiye kadar, 2. ve 6. interkostal boşluklar arasında tanımlanan kalp alanı daha doğruydu. Penetran kardiyak travmada %97.3, özgüllük %72, pozitif prediktif değer %33, negatif prediktif değer %99.4 ve %75.1 hassasiyete sahiptir. ROC 0.894 IC %95 (0.760–0.901) idi. TARTIŞMA: Torasik bölgeler arasında, sağ orta klavikula çizgisi ile sol ön aksiller çizgisi ve 2. ve 6. interkostal boşluklar arasındaki topografik sınırlamalar daha kesindir ve toraks ile SW hastalarında kalp yaralanmasının yüksek göstergesidir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Montenegro Muñoz J, Dussan O, Ruiz F, RUBIANO ESCOBAR A, Puyana J (2020). Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. , 693 - 698. 10.14744/tjtes.2020.70503
Chicago	Montenegro Muñoz Jorge Hernan,Dussan Oscar,Ruiz Francisco,RUBIANO ESCOBAR ANDRES MARIANO,Puyana Juan Carlos Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. (2020): 693 - 698. 10.14744/tjtes.2020.70503
MLA	Montenegro Muñoz Jorge Hernan,Dussan Oscar,Ruiz Francisco,RUBIANO ESCOBAR ANDRES MARIANO,Puyana Juan Carlos Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. , 2020, ss.693 - 698. 10.14744/tjtes.2020.70503
AMA	Montenegro Muñoz J,Dussan O,Ruiz F,RUBIANO ESCOBAR A,Puyana J Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. . 2020; 693 - 698. 10.14744/tjtes.2020.70503
Vancouver	Montenegro Muñoz J,Dussan O,Ruiz F,RUBIANO ESCOBAR A,Puyana J Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. . 2020; 693 - 698. 10.14744/tjtes.2020.70503
IEEE	Montenegro Muñoz J,Dussan O,Ruiz F,RUBIANO ESCOBAR A,Puyana J "Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area." , ss.693 - 698, 2020. 10.14744/tjtes.2020.70503
ISNAD	Montenegro Muñoz, Jorge Hernan vd. "Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area". (2020), 693-698. https://doi.org/10.14744/tjtes.2020.70503

APA	Montenegro Muñoz J, Dussan O, Ruiz F, RUBIANO ESCOBAR A, Puyana J (2020). Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. Ulusal Travma ve Acil Cerrahi Dergisi, 26(5), 693 - 698. 10.14744/tjtes.2020.70503
Chicago	Montenegro Muñoz Jorge Hernan,Dussan Oscar,Ruiz Francisco,RUBIANO ESCOBAR ANDRES MARIANO,Puyana Juan Carlos Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. Ulusal Travma ve Acil Cerrahi Dergisi 26, no.5 (2020): 693 - 698. 10.14744/tjtes.2020.70503
MLA	Montenegro Muñoz Jorge Hernan,Dussan Oscar,Ruiz Francisco,RUBIANO ESCOBAR ANDRES MARIANO,Puyana Juan Carlos Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. Ulusal Travma ve Acil Cerrahi Dergisi, vol.26, no.5, 2020, ss.693 - 698. 10.14744/tjtes.2020.70503
AMA	Montenegro Muñoz J,Dussan O,Ruiz F,RUBIANO ESCOBAR A,Puyana J Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(5): 693 - 698. 10.14744/tjtes.2020.70503
Vancouver	Montenegro Muñoz J,Dussan O,Ruiz F,RUBIANO ESCOBAR A,Puyana J Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area. Ulusal Travma ve Acil Cerrahi Dergisi. 2020; 26(5): 693 - 698. 10.14744/tjtes.2020.70503
IEEE	Montenegro Muñoz J,Dussan O,Ruiz F,RUBIANO ESCOBAR A,Puyana J "Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area." Ulusal Travma ve Acil Cerrahi Dergisi, 26, ss.693 - 698, 2020. 10.14744/tjtes.2020.70503
ISNAD	Montenegro Muñoz, Jorge Hernan vd. "Penetrating cardiac trauma in stab wounds: A study of diagnostic accuracy of the cardiac area". Ulusal Travma ve Acil Cerrahi Dergisi 26/5 (2020), 693-698. https://doi.org/10.14744/tjtes.2020.70503