Predicting Factors for Cardiovascular Injuries and and Indication for Emergency Echocardiography in Sternal Fractures

Kim, Chan Woong; Ryu, Ji Yeong; Cheon, Young Jin

Abstract

OBJECTIVE
To determine the predicting factors related to cardiovascular injuries and To suggest a clinical indication for emergency echocardiography in sternal fractures.
METHODS AND RESULTS
A total mumber of 40 patients with sternal fractures a over 5-year period were retrospectively assessed on clinical, echocardiographic and biochemical status. We analyzed the following 4 factors as predicting factors for cardiovascular injuries in sternal fractures : 1) presence of restraint, 2) presence of associated injuries, 3) presence of a past medical history involving cardiovascular system, 4) Revised Trauma Score(RTS). We, also, assessed the utility of conventional diagnostic methods for cardiovascular injuries, such as ECG, chest X-ray, and enzyme levels. Based on the methods, we tried to infer an indication for emergency echocardiography in sternal fractures.
RESULTS
The presence of a past medical history involving cardiovascular system and abnormal RTS on admission were significant predicting factors. Emergency echocardiography was performed according to the predicting factors and the results from conventional evaluations. These data can suggest that indications for emergency echocardiography in sternal fractures include as 1) if more than two studies reveal abnormality without any significant predicting factors. 2) if more than one study reveal abnormality with any significant predicting factors.
CONCLUSION
The past medical history involving cardiovascular system and initial vital signs imply the presence of associated cardiovascular injuries in sternal fractures. And if possible, emergency echocardiography is recommended.