Objective To analyze the clinical characteristics and prognostic factors of patients with traumatic cardiac laceration. Methods The clinical data of adult patients diagnosed with cardiac trauma in 2012 were collected from the American National Trauma Data Bank (NTDB) database, and the clinical characteristics and prognosis of cardiac laceration patients and other cardiac trauma patients were compared. The influencing factors of in-hospital death in cardiac laceration patients were determined using univariate and multivariate analyses. Results Among all 830 785 trauma patients in NTDB database in 2012, cardiac trauma patients accounted for 0.41% (3 387 cases), including 1 437 (42.43%) patients with cardiac laceration and 1 950 (57.57%) patients with other cardiac trauma. Compared with other cardiac trauma patients, cardiac laceration patients were characterized with younger age, less White race, less comorbidities, more males, more uninsured, more admitted to level Ⅰ trauma designation and teaching hospitals, more firearm or explosive injury and cutting or piercing instrument injury, more penetrating injury of the cardiac cavity, more associated penetrating injury of the chest wall, traumatic hemothorax/pneumothorax and lung contusion, more surgery treatment, and more serious vital signs and higher trauma scores on admission (all P<0.01). Of the 1 437 patients, 467 were dead on arrival, 507 died in hospital, and the remaining 463 survived and discharged from hospital. Multivariate logistic regression analysis showed that age ≥ 50 years, uninsured, comorbidities, injury due to motor vehicle, injury severity score ≥ 25, severe arrhythmia, associated lung contusion, systolic blood pressure< 90 mmHg (1 mmHg=0.133 kPa), oxygen saturation< 90% and core temperature< 36℃ on admission, and exploratory thoracotomy were independent risk factors for in-hospital death of cardiac laceration patients (all P<0.01). Cutting or piercing instrument injury, respiratory rate on admission ≥ 20 min^-1 and cardiac or pericardial repair were independent protective factors for in-hospital death in adult patients with cardiac laceration (all P<0.01). Conclusion The proportion of traumatic cardiac laceration is high and the survival rate is low in cardiac trauma patients. Cardiac laceration is more critical than other cardiac traumas. There are many influencing factors for its prognosis, and more attention should be given to cardiac laceration research.