Pelvic Fracture and Risk Factors for Mortality: A Population-Based Study in Taiwan

Chien, Li Chien; Cheng, Hon Mei; Chen, Weng Chau; Tsai, Ming-Chao

doi:10.1007/s00068-009-9094-0

Cited by 18 publications

(16 citation statements)

References 26 publications

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“…Often the result of high-energy trauma in young individuals 1 – 3 and low-energy injury in older people, 4 – 7 pelvic ring fractures are associated with considerable morbidity, 8 – 10 high mortality rates, 9 , 11 and significant cost to the society. 12 , 13 Estimates report the incidence of pelvic ring fractures between 2% and 8% of all fractures, 3 , 5 , 14 although the frequency may be as high as 25% in patients with multiple trauma. 3 , 15 , 16 Additionally, with an aging population, the burden of low-energy pelvic fractures will likely continue to affect a growing number of individuals.…”

Section: Introductionmentioning

confidence: 99%

A Nationwide Analysis of Pelvic Ring Fractures

Buller

Best

Quinnan

2015

Geriatr Orthop Surg Rehabil

112

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Background:Previous studies evaluating the epidemiology of pelvic ring fractures and predictors of mortality are largely based upon non-US populations, potentially limiting their generalizability. This study sought to analyze trends of pelvic ring fractures and associated complications in the United States using the largest and most recent national data set available. The specific aims of this study were to determine whether the incidence of pelvic ring fractures changed over time, whether in-hospital mortality following pelvic ring fracture changed over time, whether hospital length of stay following pelvic ring fracture changed over time, and whether there are independent predictors of in-hospital mortality, adverse events, or nonroutine discharge following pelvic fracture.Methods:The National Hospital Discharge Survey was queried to identify all patients admitted to US hospitals with pelvic ring fractures between 1990 and 2007. A cohort representative of 1 464 458 patients was identified, and multivariable logistic regression was used to find independent predictors of mortality, adverse events, and nonroutine discharge to another inpatient facility.Results:Between 1990 and 2007, the population-adjusted incidence of pelvic ring fractures increased from 27.24 to 34.30 per 100 000 capita (P < .001). Mortality declined from 4.2% to 2.8% (P < .001) paralleling an increase in the proportion of patients treated with surgical fixation (7.22%-10.36%). All forms of internal fixation were associated with decreased odds of mortality, while external fixation was associated with increased odds of mortality. Internal fixation was also associated with lower odds of adverse events and nonroutine discharge to inpatient facilities. The average in-hospital length of stay decreased from 11.2 days to 6.5 days (P < .001).Conclusion:This study provides the largest and most comprehensive epidemiologic analysis of pelvic ring fractures in the United States. Knowledge of the increasing incidence of pelvic fractures and prognostic factors associated with poor outcomes may improve outcomes.

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Section: Introductionmentioning

confidence: 99%

A Nationwide Analysis of Pelvic Ring Fractures

Buller

Best

Quinnan

2015

Geriatr Orthop Surg Rehabil

112

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“…In pelvic injuries, which were present in 38% of patients in our cohort, transcatheter arterial embolization is suitable for patients with type B1 fractures ("open book") (13) after laparoscopic exploration of the abdominal cavity (14). However, some studies point out that the seriousness of pelvic trauma is due to associated injuries (15)(16)(17)(18). The occurrence of pelvic traumas in blunt injuries has been reported to be 2%, with an incidence of 23/100,000 inhabitants of big cities (19,20).…”

Section: Discussionmentioning

confidence: 95%

The Occurence and Detection Of hemodynamically Significant Bleeding Into the Retroperitoneum In patients Dying Due to Blunt Traumatic-Haemorrhagic Shock

Simek¹,

Šmejkal²,

Frank³

et al. 2019

Mil. Med. Sci. Lett.

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Background: The occurrence of retroperitoneal bleeding and the manner of detection was retrospectively evaluated in patients with life-threatening traumatic bleeding. Methods: The cohort included patients who died in the Trauma Centre of the University Hospital Hradec Kralove in Czech Republic between 2008 and 2012 due to traumatic hemorrhagic shock. Findings of retroperitoneal bleeding and the findings found for life (i.e., CT, FAST, pre-operative findings) were compared. Results: During the five-year period, deaths due to the post-mortem diagnosis of traumatic hemorrhagic shock were recorded in 75 patients, 26 of which (35%) were verified by post-mortem autopsy to have hemodynamically significant bleeding into the retroperitoneum (HSBR) from 31 sources. HSBR was identified for life in 10 patients with HSBR (38.5%). Sensitivity was 55% in CT angiography and 36% in laparotomy without previous CT. The sensitivity of laparotomy with surgical exploration of the retroperitoneum was 67%. A predisposing factor for hemodynamically significant bleeding into the retroperitoneum, which may escape the surgeon's attention, is high-energy blunt trauma to the trunk. Conclusions: In the acute stage of treatment of patients with life-threatening bleeding due to high-energy blunt trauma, the surgeon has to decide whether the patient's condition allows CT and whether hematoma of the retroperitoneum should be revised surgically. However, in the present cohort few patients with HSBR underwent surgical exploration of the retroperitoneum because the hematoma was ascribed to the known injury of the pelvis and spine.

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“…Several studies found that the prognosis of traumatized with pelvic fractures is mainly related to the severity of associated injuries, and not to the complexity of the fracture itself 1,[7][8][9][10] . Demetriades et al 8 reported in 2002 that of 16,630 trauma patients with pelvic fracture, only 0.8% died from complications directly related to the fracture.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

“…However, in these cases the mortality reached 54%. It is believed that retroperitoneal bleeding may cause 7-33% of deaths when present in patients with pelvic fractures 7,11 . Parreira Parreira Parreira Parreira Parreira Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma In our service, we noticed an increase in the lethality of the blunt trauma with pelvic fractures in recent years 1 .…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

Parreira

Kanamori

Valinoto

et al. 2014

Rev. Col. Bras. Cir.

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Pelvic Fracture and Risk Factors for Mortality: A Population-Based Study in Taiwan

Cited by 18 publications

References 26 publications

A Nationwide Analysis of Pelvic Ring Fractures

A Nationwide Analysis of Pelvic Ring Fractures

The Occurence and Detection Of hemodynamically Significant Bleeding Into the Retroperitoneum In patients Dying Due to Blunt Traumatic-Haemorrhagic Shock

Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

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