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Invited Critique
Sep 2011

Hole in the Heart: Is an Echocardiogram Really Indicated 1 Month Later?Comment on “Postdischarge Complications After Penetrating Cardiac Injury”

Author Affiliations

Author Affiliation: Division of Trauma, Critical Care, and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland.

Arch Surg. 2011;146(9):1066-1067. doi:10.1001/archsurg.2011.227

Tang and colleagues1 performed a 10-year retrospective review of their patients who sustained penetrating cardiac injuries. They have shown that signs of life on admission, normal blood pressure, and a stab wound mechanism predict survival. Survival to discharge was 26.9% and postdischarge follow-up was available in 46 patients for a mean of 1.9 months. Based on the Social Security Death Index, surviving patients were more likely to die over the 9-year course of the study than age-matched comparators. They also evaluated long-term complications in survivors using a standardized protocol that includes a postoperative echocardiogram and an echocardiogram obtained 1 month after discharge. They found abnormalities in 17% of patients but all of the abnormalities seen in follow-up were present on the postoperative echocardiogram and none of the abnormalities required surgical intervention.

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