Analysis of Predicting Factors for Cardiovascular Injuries in Sternal Fractures

Kim, Chan Woong; Cho, Dai Yun; Sohn, Dong Suep; Yang, Ki Min

Abstract

BACKGROUND: The aims of this study are to determine the predicting factors related with cardiovascular injuries in sternal fractures and to suggest the indication of emergency echocardiography. MATERIAL AND METHOD: A retrospective review of the Ewha Womans University Mok-Dong Hospital trauma registry revealed 40 patients, that visited the hospital with a sternal fracture a over 5-year period. We analyzed 4 factors as predicting factors; 1) presence of restraint, 2) presence of associated injuries, 3) presence of a past medical history involving cardiovascular system, and 4) Revised Trauma Score(RTS). We, also, assessed the utility of conventional study methods involving cardiovascular injuries, such as ECG, chest X-ray, and enzyme level. Based on the methods, we inferred an indication for emergency echocardiography in sternal fractures. RESULT: Statistically significant predicting factors were the presence of a past medical history involving cardiovascular system and abnormal RTS on admission. Usage of emergency echocardiography depended upon the predicting factors and the results from conventional evaluations. We can now suggest the indications of emergency echocardiography in sternal fractures as 1) if more than two studies reveal abnormality without any significant predicting factors, and 2) if more than one study reveals abnormality with any significant predicting factors.
CONCLUSION
The past medical history involving cardiovascular system and initial vital signs imply the presence of cardiovascular injuries in sternal fractures. And if needed, emergency echocardiography should be performed.