Methods: Ninety-four patients with penetrating heart injuries (82 males, 12 females, mean age 25.9±12.7 years; range 3 to 67 years) admitted to our clinic between November 2000 and June 2010 were retrospectively evaluated. We recorded the demographic features, transfer time to hospital, way of transfer, clinical condition at admission, and reasons for the patient injuries. Additionally, the presence of hemothorax, pericardial hematoma, tamponade, coronary artery injury, the method of decision for surgery (operation following resuscitation thoracotomy, clinical follow-up or some diagnostic methods), the injured chamber of the heart, presence of accompanying injury in another organ, heart rhythm at the beginning of the surgery, and the surgical approach used were recorded.

Results: The mortality rate was 13.8% in our study. Survival was not found to be related to age, gender, reason of injury (gunshot, stabbing, iatrogenic injuries), and presence of tamponade, and coronary artery injury. However, a significant relationship was found between survival and the way of transfer (ambulance or other vehicles), transfer time to hospital, clinical condition at admission, the method of decision for surgery, heart rhythm before the surgery, presence of pericardial hematoma or hemothorax, injured heart chamber, and presence of accompanying injury in another organ.

Conclusion: The transfer time to hospital is the most important modifiable factor that may affect the outcomes in penetrating heart injuries. Shortening this time will dramatically improve the survival in these patients who have a very high mortality.