The lack of established diagnostic criteria makes diagnosing blunt cardiac injury difficult. We investigated the factors associated with blunt cardiac injury using the Japan Trauma Data Bank (JTDB) in a multicenter observational study of blunt trauma patients conducted between 2004 and 2018. The primary outcome was the incidence of blunt cardiac/pericardial injury. Multivariable logistic regression analysis was used to identify factors independently associated with blunt cardiac injuries. Of the 228,513 patients, 1002 (0.4%) had blunt cardiac injury. Hypotension on hospital arrival (adjusted odds ratio (AOR) 4.536, 95% confidence interval (CI) 3.802-5.412), thoracic aortic injury (AOR 2.722, 95% CI 1.947-3.806), pulmonary contusion (AOR 2.532, 95% CI 2.204-2.909), rib fracture (AOR 1.362, 95% CI 1.147-1.618), sternal fracture (AOR 3.319, 95% CI 2.696-4.085). and hemothorax/pneumothorax (AOR 1.689, 95% CI 1.423-2.006)) was positively associated with blunt cardiac injury. Regarding the types of patients, car drivers had a higher rate of blunt cardiac injury compared to other types of patients. Driving a car, hypotension on hospital arrival, thoracic aortic injury, pulmonary contusion, rib fracture, sternal fracture, and hemothorax/pneumothorax were positively associated with blunt cardiac injury.
Keywords: Japan; blunt cardiac injury; cardiac contusion; sternal fractures.