Risk factors of blunt cardiac injury and routine use of echocardiography in sternum fractures

Authors : Hıdır ESME, Zafer BÜYÜKTERZİ

Pages : 53-57

View : 16 | Download : 9

Publication Date : 2020-08-07

Article Type : Research Paper

Abstract :The incidence of cardiac injury related with sternal fracture ranges from 18.0% to 62.0%. Our aim in the study is to reveal the risk factors of blunt cardiac injury in patients with sternum fractures and to determine the necessity of routine use of echocardiography in diagnosis. 64 patients with sternum fracture due to blunt trauma between 2010 and 2018 were examined. Patients were retrospectively evaluated for age, gender, cause of trauma, fracture localization insert ignore into journalissuearticles values(manubrium or corpus);, fracture type insert ignore into journalissuearticles values(displacement or nondeplase);, treatment methods, complications, electrocardiography insert ignore into journalissuearticles values(ECG); and echocardiography findings insert ignore into journalissuearticles values(ECO);, cardiac enzyme insert ignore into journalissuearticles values(Creatine kinase myocardial band insert ignore into journalissuearticles values(CK- MB); and Troponin I); levels, length of intensive care and hospital stay. The cause of the sternum fracture was the in-vehicle traffic accident in 39 insert ignore into journalissuearticles values(60%); patients, and 31 insert ignore into journalissuearticles values(79.4%); of these patients were wearing seat belts. Twenty-two insert ignore into journalissuearticles values(34.3%); of the patients were non-vehicle traffic accidents and three insert ignore into journalissuearticles values(4.6%); were falling from height. When the fracture localization was examined, 49 insert ignore into journalissuearticles values(76.5%); of the patients had fractures in the corpus and 15 insert ignore into journalissuearticles values(23.4%); of the manubrium. 29 of the sternal fractures were displaced insert ignore into journalissuearticles values(45.3%);. Acute ECG change was detected in 15 insert ignore into journalissuearticles values(23.4%); of the patients. Cardiac enzyme height was determined in 11 insert ignore into journalissuearticles values(17.1%); patients. ECG and cardiac enzyme results were evaluated together and ECO was performed in 17 insert ignore into journalissuearticles values(26.5%); patients for differential diagnosis of cardiac pathology. Minimal pericardial effusion was detected in 4 insert ignore into journalissuearticles values(6.2%); of the patients, while myocardial contusion or vascular pathology was not observed. A significant relation was found between the displacement of the sternum fracture and age, high cardiac enzyme values and abnormal ECO findings. However, there was no significant relationship between gender, acute abnormal ECG findings, length of intensive care and hospital stay. Although the rate of serious cardiac injury is low in sternum fractures, ECG and cardiac enzyme examination should be performed in all patients due to high morbidity and mortality. Additional ECO examination should be performed in advanced age patients and displaced corpus stern fractures.
Keywords : künt kardiyak yaralanma, ekokardiyografi