Prevalence of Stress Cardiomyopathy in Polytrauma Patients

Abstract

Background: Polytrauma is a leading cause of death globally and usually involving young victims. Takotsubo cardiomyopathy (TCM) is a serious clinical presentation of myocardial dysfunction characterized by acute, transient, and reversible heart failure syndrome owing to regional wall abnormalities of the ventricular myocardium associated with ECG changes and rising of myocardial biomarkers in the absence of cardiac condition causing the temporary ventricular dysfunction. Objective: To detect the prevalence of stress cardiomyopathy among polytrauma patients attending to Emergency Hospital Mansoura University. Patients and methods: The current study was a cross sectional study conducted on 500 patients who attended to Emergency Department, Emergency Hospital Mansoura University, suffering from polytrauma within the period from August 2019 to August 2020. Results: Prevalence of cardiomyopathy among the studied trauma patients was 4.4%. Mode of trauma (either blunt or penetrating) had no effect in the incidence of cardiomyopathy. Sequential organ failure assessment (SOFA) score and revised trauma score (RTS) demonstrated positive correlation with incidence of cardiomyopathy among polytrauma cases (P<0.001). Cardiomyopathy group was associated with marked affection of all echocardiographic parameters (Stroke volume, end diastolic volume, ejection fraction and fractional shortening) except end systolic volume. Cardiomyopathy group was associated with marked increase in ICU admission, ICU length of stay, total length of stay and mortality rate. Conclusion: Presence of stress cardiomyopathy in trauma cases may be used as an indicator of poor outcomes. Both SOFA and RTS scores were considered as reliable tools used to describe organ dysfunction/failure in polytrauma cases and have a positive correlation with stress cardiomyopathy.