BACKGROUND: To analyze the demographics and outcomes, from a large number of civilian cardiovascular (CCV) trauma cases, prospectively registered at a level I Brazilian Trauma Center. METHODS: This paper deals with cardiovascular traumas studied in a prospective, descriptive and analytic way registered between 1998 through 2005. RESULTS: Over 7-year period, 1000 patients were surgically approached. Most patients were young males with gunshot, stab wound/glasses and blunt trauma, distributed at the abdomen, neck, torso and more frequent at the limbs. The three main syndromes observed at admission were: hemorrhagic, ischemic and hemorrhagic/ischemic. Severe shock at admission was present in 34.6% of the patients, and non cardiovascular associated injuries were present in 85% of the cases. Most of the patients were operated on without preoperative tests. A second operation was required in 14%, because of the following reasons: peripheral compartmental syndrome, acute arterial thrombosis or major hemorrhage. The amputation rate was 5.5% and mortality rate was 7.5% at discharge. Severe hemorrhagic shock and multiple organ failure were the main causes of death. Isolated CCV lesion was present in 15%, with a global lethality of 41 %. Deaths were attributed to the following causes: venous (22%), arterial (47%) and cardiac (81%) with statistical significance between cardiac lesions versus arterial plus venous lesions (p = 0.01; odds ratio = 7.37) and arterial lesions versus venous lesions (p = 0.01; odds ratio 3.17). CONCLUSION: This large number of cases showed that the main victims were young men, involved on personal violence or vehicle crash accidents, with lesions more frequently found at the extremities with high association with non cardiovascular injuries. The negative prognostic predictive factors were severe shock, large artery lesions or cardiac injuries.
Cardiovascular System; Wounds and injuries; Ischemia; Reperfusion; Evidence-based medicine; Epidemiology; Vascular surgical procedures
