Analysis of 285 cardiac penetrating injuries in the Lebanon war

J Cardiovasc Surg (Torino). Jul-Aug 1987;28(4):380-3.

Abstract

This study evaluates factors influencing survival in 285 battle cardiac injuries, treated in Lebanon from 1969 to 1982. Survival factors included age (mean 18 years), transportation lag (mean distance 2 miles), wounding agents (shrapnel, gunshot), hospital logistics, and early surgical treatment. The overall survival was 73% (208 patients) compared to 60% from World War II and 67% from recent civilian report. Treatment logistics included a specialized centre with ambulance radio communication. The state of shock at arrival influenced survival: 146 of 188 patients with mild shock survived (78%) with 61% (53 patients) survival in the profound shock group, treated similarly. The site of cardiac injury influenced outcome. Survival was best in the 9 patients with coronary vessel wounds (100%), atrial wounds 80% (56 survivors) but dropped to 46% (17 survivors) in left ventricular injury reflecting pump failure, and 51% (19 survivors) in multiple cardiac wounds. The causes of cardiac mortality and survivor follow-up were evaluated. The study indicates that despite predetermined factors overall survival is significantly improved by early transportation, precise logistics, and urgent surgery.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Heart Injuries / mortality
  • Heart Injuries / surgery*
  • Humans
  • Male
  • Resuscitation
  • Shock, Traumatic / physiopathology
  • Time Factors
  • Transportation of Patients
  • Wounds, Gunshot / surgery
  • Wounds, Nonpenetrating / surgery
  • Wounds, Penetrating / mortality
  • Wounds, Penetrating / surgery*