Title

Predictors for survival of penetrating trauma using emergency department thoracotomy in an urban trauma center: the Cardiac Instability Score.

Document Type

Article

Publication Date

2-1-2010

Abstract

BACKGROUND: Emergency department thoracotomy (EDT) is a procedure used in an attempt to save lives of patients in extremis. This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of penetrating trauma undergoing EDT.

METHODS: This retrospective study analyzes patients who underwent EDT during a 45-month period at Howard University Hospital, Washington, DC. Vital signs and Glasgow Coma scale (GCS) scores were analyzed at the scene and in the emergency department. A cardiac instability score (CIS) was devised to assign values to vital signs, and the GCS was based on scores from the emergency department.

RESULTS: Emergency department vital signs, female gender, absence of cardiopulmonary resuscitation (CPR), and high CIS were found to be statistically significant predictors of survival.

CONCLUSIONS: The CIS correlated with survival of patients who underwent EDT and was found to be statistically significant in determining the outcome of an EDT.

Journal Title

Journal of the National Medical Association

Volume

102

Issue

2

First Page

126

Last Page

130

MeSH Keywords

Emergency Service, Hospital; Glasgow Coma Scale; Health Status Indicators; Humans; Prognosis; Retrospective Studies; Thoracotomy; Urban Population; Wounds, Penetrating

Keywords

Penetrating Trauma; Cardiac Instability Score; ER; Survival

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