Patterns, Management and Outcomes of Traumatic Pelvic Fracture: Insights from A Multicenter Study

Abstract

Purpose we aimed to describe traumatic pelvic fracture in multinational level 1 trauma centers. Methods We conducted a retrospective analysis for all patients with traumatic pelvic fracture (TPF) between 2010 and 2016 at 2 trauma centers in Qatar and Germany. Results A total of 2112 patients presented with traumatic pelvic injuries of which 1814 (85.9%) sustained TPF, males dominated (76.5%) with a mean age of 41.2±21.1 years. Falls, motor vehicle crashes and pedestrians were the most frequent mechanisms involved. Chest (37.3%) was the most commonly associated injured region, with mean injury severity score (ISS) of 16.5±13.3. Hemodynamic instability was observed in 44%, blood was needed in a third, massive transfusion in a tenth and intensive care admission in a quarter of cases. Tile classification was possible in 1228 patients (type A in 60%, B in 30% and C in 10%). Patients with type C had higher rates of associated injuries, ISS, pelvis abbreviated injury score (AIS), more need for blood transfusion, massive transfusion protocol activation, prolonged hospital stay, higher rate for surgery, complications, and mortality (p<0.001). Two-thirds of patients were managed conservatively while a third needed surgical fixation. The median length of hospital and intensive care stay were 15 and 5 days, respectively. In-hospital complications were few and the overall mortality rate was 4.7% (86 patients). Conclusion pelvic fracture is a common injury. It needs a careful multidisciplinary and systematic approach to address the associated complexities and polytrauma nature in order to improve the associated outcomes both on a short and long-term basis.