PATTERN OF INJURIES TO HEART AND ITS MEDICOLEGAL ASPECTS- AN AUTOPSY BASED STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 41
Abstract
BACKGROUND Injuries of the chest causing disruption of the thoracic cage and damage to the heart are increasing daily. The anatomic location of the heart makes it susceptible to trauma. All cardiac injuries have potential to increase the amount of morbidity and mortality with great medicolegal impact and contribute to 25% of trauma-related deaths. MATERIALS AND METHODS In this study, we analysed the pattern of cardiac injury and the socio-demographic pattern of the victims in trauma. 250 cases brought to a tertiary care institution for autopsy were studied from 1st January 2005 to 30th November 2005 (1st July 2005 - 30th November prospectively and 1st January - 30th June 2005, retrospectively). A cross-sectional study including all cases of trauma to the thorax and heart with consecutive sampling was done. Data was collected in proforma and analysed. RESULTS 206 were males (Table 1). Commonest cause of chest injury was trauma. 130 (52%) were victims of road traffic accidents (Table 2, Figure 1) and the vehicle implicated the most was bus (41 cases, 16.4%, Table 3, Figure 2). Pedestrians constituted the majority (26.4%, Table 4, Figure 3). 70.6% belonged to the working age group (21 - 60 years, Table 5). 104 (41.6%) were brought dead to the hospital (Table 6). Pericardial injuries were seen in 12 cases, laceration in 7, incised wounds in 3, transfixation and contusion contributed to 1 each (Table 8). Cardiac trauma was seen in 24 cases (9.6%), comprising contusion in 8 (3.2%), laceration in 9(3.6%), cavity terminating in 3 (1.2%), avulsion in 3 (1.2%) and 1 transfixation (0.4%) (Table 9). The most commonly affected part of the heart was right ventricle (7 cases, 2.8%, Table 9, Figure 4) and front surface (6.4%, Table 10). 5 cases showed haemopericardium (Table 11). In 193 (77.2%) cases, the cause of death was chest injuries (Table 14, Figure 6). CONCLUSION There is little that the autopsy surgeon can contribute to elucidate the factors leading to accidental deaths. Multiple regression is useful to correlate between predictor and outcome variables. Hopefully, future research will improve the methodology to predict the outcome of cardiac trauma accurately.
Authors and Affiliations
Thankamma P. George, Vitni Fernz
Keywords
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- EP ID EP548360
- DOI 10.14260/jemds/2018/989
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