Preventable mortality following sharp penetrating chest trauma.

We examined the determinants of outcome following sharp penetrating chest trauma (SPCT) in Cape Town, South Africa. During a 6-month period, 248 nonsurvivors (comprising 231 prehospital and 17 in-hospital deaths) and 474 survivors admitted to the Groote Schuur Hospital Trauma Unit were located. Most (77%) of the deaths resulted from cardiac or great vessel injuries. An unexpected finding was that in 47 (19%) of the prehospital deaths, the only injury at autopsy was a unilateral lung wound. There were no deaths in the 442 patients with this injury admitted to the hospital. The survival rate following equivalent injuries was unexpectedly better in patients from poorer socioeconomic areas, possibly because of increased use of private transport to reach the hospital. The key to improved outcome after survivable SPCT lies in rapid transportation to adequate emergency care by the quickest available means.