Patients with pelvic fracture: what factors are associated with mortality? (original) (raw)
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Epidemiological study of major pelvic fracture in Hong Kong and analysis of predictors for mortality
Hong Kong Journal of Emergency Medicine, 2019
Objectives and Background Pelvic fracture causes significant mortality and morbidities. The purpose of this study is to identify the characteristics of patients with pelvic fracture in Hong Kong and to determine the factors predicting mortality. The result could help to identify high-risk patients who might benefit from more intensive evaluation and intervention. Method: Five hundred and eight patients (age > 12 years old) with pelvic fractures were identified from the trauma registries of four designated trauma centres in Hong Kong from 1 January 2005 to 31 December 2012. Patient baseline characteristics and outcomes were analysed. Stepwise logistic regression was performed to identify independent clinical predictors for mortality. Result: Mean age was 45.4 ± 19.2 years, 43.3% were female, mean length of hospital stay was 27.9 ± 42.4 days and mean length of intensive care unit stay was 4.8 ± 6.8 days. Injury severity score was 28.9 ± 18.7, revised trauma score was 7.2 ± 2 and 30-day mortality was 20.9%. Stepwise logistic regression identified patient’s age, presenting systolic blood pressure, initial Glasgow Coma Scale, injuries to the thoracic and abdominal regions, first base excess and the volume of red blood cell transfusion required within the first 6 h to be independent risk factors predicting mortality. Conclusion: Pelvic fracture is associated with significant risk of mortality in major trauma patients. Clinical characteristics obtained during emergency department resuscitation can help in selecting patients for timely aggressive interventions
Pelvic Fracture and Risk Factors for Mortality: A Population-Based Study in Taiwan
European Journal of Trauma and Emergency Surgery, 2010
Objective: To study the incidence, demographics, distribution of fracture sites, associated injuries, and risk factors for the outcomes of pelvic fracture on a population basis. Methods: An annual claim dataset from 2001 to 2003 was retrieved from the Bureau of National Health Insurance (BNHI) trauma database with any International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) coded as pelvic fracture. Statistical analyses were conducted to discover the association between variables such as age, gender, month of injury, injury mechanisms, associated injuries, and outcome. Results: Pelvic fracture was diagnosed in 10,109 patients (4,693 males, 46.4%) and 384 patients (3.8%) died. The incidence was 14.97/100,000 person-years. The mean length of stay was 9.3 days (females, 8.8 days; males, 9.9 days; p < 0.01) and the average cost per patient was US$1,475. Both were affected by age, gender, and hospital accreditation level and ownership. There were more female cases in the age groups over 44 years old. Head injury (excluding concussion), associated chest and abdominal injuries, open pelvic fracture, and the transfusion of more than four units of blood significantly increased the risk of mortality. Conclusions: The incidence rate of pelvic fracture was higher in females over 44 years of age, but the average medical resource use was higher in males. Associated injuries were stronger positive factors for the risk of mortality than gender, fracture sites, injury mechanisms, and the characteristics of the treating hospitals.
Epidemiology of pelvic fractures in adults: Our experience at a tertiary hospital
Chinese Journal of Traumatology, 2019
Pelvic fractures are severe injuries and are often associated with multiple system injuries, exacerbating the overall outcome. In India, the incidence of pelvic fractures is on a rise due to suboptimal roads and traffics but related literature regarding the overall epidemiology of these injuries is scarce and scanty. Our aim was to study the epidemiology of patients admitted with pelvic fractures at a level 1 trauma centre in India. Methods: A 16-month (between September 2015 and December 2016) prospective observational study was carried out on trauma patients with pelvic fractures at a level 1 trauma centre of a tertiary care hospital. Demography of patients, mechanism of injuries and complications were recorded prospectively. Results: We observed 75 patients who presented with pelvic fractures, where 56 were males and 19 were females. Mean age of the study population was 37.57 years. Road traffic accidents were the most common mode of injuries. Lateral compression injuries were the most common pattern. Associated injuries frequently encountered were lower extremities and acetabulum fractures, blunt abdominal trauma, urogenital injuries and head injuries. Out of the 75 patients, 52 were treated surgically and 23 were managed by conservative methods. Associated injuries of the extremities, head, abdomen and urogenital system indicated a longer hospital stay. Conclusion: Pelvic fractures, although belong to a relatively rare trauma subset, cause a high morbidity and mortality with considerable burden on the economy. Proper road safety training and driving etiquettes along with its strict implementation in true sense and spirit are the need of the hour.
International Orthopaedics, 2018
Purpose The primary objective was to identify the predictors of in-hospital mortality after pelvic ring injuries. Secondary objectives were to analyze the differences between adults and children and to analyze the causes and timing of death. Methods A retrospective cohort study from the pelvic registry of Assiut University Trauma Unit (AUTU), a level 1 trauma centre in Upper Egypt, was carried out. A total of 1188 consecutive patients with pelvic ring fractures treated from January 2010 to December 2013 were eligible for analysis. Potential predictors were identified using standard statistical tests: univariable and multivariable regression analysis. Results Nine hundred fifty-one were adults (above 16 years) and 237 were children. According to Tile's classification, fractures type A, B, and C were 31.8%, 25.1%, and 43.1%, respectively. About a third of patients had fractures with soft tissue injury. Abdominopelvic collection as diagnosed by Focused Assessment with Sonography for Trauma (FAST) was positive in 11%. Associated injuries were present in 67.3% with abdominal-urogenital injuries being the most prevalent (66.3%). Median hospital stay was five days. Fifty-two patients (4.4%) were admitted to the ICU. One hundred three patients died (8.7%) within two peaks: first 24 hours and between 48 hours and one week. Multivariable logistic regression analysis identified increasing age, fractures with soft tissue injury, associated head injury, positive FAST examination, and admission to an ICU as significant predictors of inhospital mortality. Conclusions The first 24 hours were confirmed to be critical for survival in pelvic fracture patients. Advancing age, associated soft tissue injury, associated head injury, admission to ICU, and positive FAST examination can serve as reliable predictors for an elevated mortality risk in such patients.
Journal of Clinical Orthopaedics and Trauma, 2020
In Bangladesh the incidence of pelvic fracture is increasing day by day due to suboptimal roads and heavy traffic. However, there is no epidemiological study of these injuries in Bangladesh. Our aim was to study the epidemiology of patients admitted with pelvic fractures at two tertiary care hospital in Dhaka, Bangladesh. Methods: This was a prospective study carried out on trauma patients with pelvic fracture at two level 1 trauma care center of two tertiary care hospital in Dhaka, Bangladesh. The study period was from July 2015 to June 2019 (48 months). Patient's data including demography of patients, mechanism of injuries, fracture types, associated injuries, method of treatment, post-operative complications, length of hospital stay were recorded according to a unified protocol. Results: The study population was comprised of 696 patients, where 556 (79.88%) were male and 140 (20.12%) were female. Mean age was 37.75 years and road traffic accidents were the most common mode of injuries. Lateral compression fractures were the most common injuries and Urethral injuries were the most common associated injuries. Death was the outcome in 3.5% of the cases due to high energy trauma. Conclusion: This study revealed that pelvic fractures were significantly more frequent in men. Most frequent cause was road traffic accident. The majority of these cases did not required surgery. Mortality was associated with high velocity trauma with severe injuries.
The role of pelvic fractures in the course of treatment and outcome of trauma patients
The Israel Medical Association journal : IMAJ, 2005
Pelvic fracture poses a complex challenge to the trauma surgeon. It is associated with head, thoracic and abdominal injuries. As pelvic fracture severity increases so does the number of associated injuries and the mortality rate. To report our experience in the treatment of pelvic fractures. Between October 1998 and September 2001, 78 patients with pelvic fractures were admitted to our hospital. The age range of the 56 male and 22 female patients was 16-92 (mean 42 years). The cause of injury was road accident in 52 patients, fall from a height in 15, a simple fall in 9, and gunshot wounds in 2 patients. The Glascow Coma Scale score on arrival at the hospital was 3-15 (average 12). Twenty-five patients (32%) were admitted to the intensive care unit, 38 (48%) to the orthopedic department, 5 (6.4%) to neurosurgery and the remainder to a surgical department. Twenty-six patients (33.3%) received blood transfusion in the first 24 hours. Of the 25 patients with associated head trauma, 6 h...
Mortality in Patients With Pelvic Fractures: Results From the German Pelvic Injury Register
The Journal of Trauma: Injury, Infection, and Critical Care, 2008
Background: Pelvic and acetabular fractures are rare injuries and account for approximately 3% to 8% of all fractures. Often the result of high energy blunt trauma, most of the patients sustaining pelvic injuries are at high risk of associated injuries strongly influencing outcome and survival rates. Because of anatomic differences it has been suggested that pediatric pelvic fractures are different injuries as compared with that of adults. However, this has been controversially discussed. Aim of this multicenter register study was to identify similarities and differences between pediatric and adult pelvic trauma and evaluate the influence of changes in medical treatment by comparison of two treatment periods.
Traumatic Pelvic Fractures Hospitalized in Kasr Al-Ainy Hospital in 2018: A Retrospective Study
The Egyptian Journal of Forensic Sciences and Applied Toxicology, 2019
Major pelvic fractures are predominantly observed when there is a highenergy transfer to the patient such as following road traffic collision, pedestrian accident, fall from height, or crush injury. Less serious pelvic fractures may occur with low-energy transfer events, particularly in the elderly. Objectives: The aim of the current study is to statistically assess the prevalence, common causes, management and outcome of pelvic fracture cases admitted to Kasr Al-Ainy hospital through the year 2018. Subjects and methods: The data presented in this study were obtained from the bureau of statistics at Kasr Al-Ainy hospital. One hundred ninety six cases with traumatic pelvic fractures were admitted to Kasr Al-Ainy hospital during the one year period study from January 2018 to December 2018. Results: the incidence of traumatic pelvic fractures in the present study was higher in males, urban areas and day time. The age group 21-40 was associated with a higher percentage of traumatic pelvic fractures was recorded and a mean age was 35 years. Road traffic accidents were the commonest cause followed by fall from height. A higher incidence of multiple pelvic fractures and the higher percentage of cases was treated surgically. Improvement was the major outcome while death was associated with the old age group above 61 years. Conclusion and recommendations: there is a need to decrease the number of road traffic accidents and greater precautions should be taken against the risks of fall from height. Old age group should be managed with special care.