Literature DB >> 12352563

Pelvic ring disruptions: prediction of associated injuries, transfusion requirement, pelvic arteriography, complications, and mortality.

Adam J Starr1, Damian R Griffin, Charles M Reinert, William H Frawley, Joan Walker, Shelley N Whitlock, Drake S Borer, Ashutosh V Rao, Alan L Jones.   

Abstract

OBJECTIVE: To determine if age, fracture pattern, systolic blood pressure on arrival, base deficit, or the Revised Trauma Score is predictive of mortality, transfusion requirements, use of pelvic arteriography, later complications, or injuries associated with the pelvic ring disruption. STUDY
DESIGN: Retrospective review of a prospectively collected database.
METHODS: All closed pelvic ring disruptions seen between November 1, 1997 and November 30, 1999 were included. Predictive variables and outcome variables were recorded for each patient. Statistical analysis was used to determine if the above variables were predictive.
RESULTS: Shock on arrival and the Revised Trauma Score were significantly associated with mortality, transfusion requirement, Injury Severity Score, and all the Abbreviated Injury Scores except the one for skin. In addition, the Revised Trauma Score was significantly associated with the use of pelvic arteriography and predicted more complications than did shock on arrival. Age was significantly associated with transfusion requirement, Injury Severity Score, the chest and skin Abbreviated Injury Scores, use of arteriography, and death. The mortality rate among patients who presented in shock was 57 percent. A Revised Trauma Score of less than 11 predicted mortality with a sensitivity and specificity of 58 percent and 92 percent, respectively. Shock on arrival predicted mortality with a sensitivity and specificity of 27 percent and 96 percent, respectively. Age greater than sixty years predicted mortality with a sensitivity and specificity of 26 percent and 91 percent, respectively. In our analysis of the fracture patterns, we were unable to demonstrate consistent, meaningful links between specific fracture classes and the outcome variables.
CONCLUSIONS: Shock on arrival and the Revised Trauma Score are useful predictors of mortality and transfusion requirements, Injury Severity Score, and Abbreviated Injury Scores for the head and neck, face, chest, abdomen, and extremities. In addition, the Revised Trauma Score predicts the use of pelvic arteriography and later complications. Age predicted transfusion requirement, Injury Severity Score, the chest and skin Abbreviated Injury Scores, use of arteriography, and death.

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Mesh:

Year:  2002        PMID: 12352563     DOI: 10.1097/00005131-200209000-00003

Source DB:  PubMed          Journal:  J Orthop Trauma        ISSN: 0890-5339            Impact factor:   2.512


  39 in total

1.  Multidisciplinary management of blunt pelvic trauma.

Authors:  Pavan Khanna; Ho Phan; Andrew Hal Hardy; Timothy Nolan; Paul Dong
Journal:  Semin Intervent Radiol       Date:  2012-09       Impact factor: 1.513

2.  Emergency Transfusion Score (ETS): a useful instrument for prediction of blood transfusion requirement in severely injured patients.

Authors:  C A Kuhne; R P Zettl; M Fischbacher; R Lefering; S Ruchholtz
Journal:  World J Surg       Date:  2008-06       Impact factor: 3.352

3.  Sepsis in fatal pelvic trauma patients: report from a level-1 Indian Trauma Centre.

Authors:  S Lalwani; N Rajkumari; P Mathur; V Sharma; V Trikha
Journal:  Eur J Trauma Emerg Surg       Date:  2015-02-20       Impact factor: 3.693

Review 4.  Preperitoneal pelvic packing for exsanguinating pelvic fractures.

Authors:  Clay Cothren Burlew
Journal:  Int Orthop       Date:  2017-04-26       Impact factor: 3.075

5.  Preperitoneal pelvic packing reduces mortality in patients with life-threatening hemorrhage due to unstable pelvic fractures.

Authors:  Clay Cothren Burlew; Ernest E Moore; Philip F Stahel; Andrea E Geddes; Amy E Wagenaar; Fredric M Pieracci; Charles J Fox; Eric M Campion; Jeffrey L Johnson; Cyril Mauffrey
Journal:  J Trauma Acute Care Surg       Date:  2017-02       Impact factor: 3.313

6.  [Control of diffuse bleeding in unstable pelvic fractures with compression plate packing: presentation of the surgical technique].

Authors:  A Biewener; S Rammelt; J Heineck; R Grass; H Zwipp; J Pyrc
Journal:  Unfallchirurg       Date:  2011-06       Impact factor: 1.000

7.  Improvement of outcomes in patients with pelvic fractures and hemodynamic instability after the establishment of a Korean regional trauma center.

Authors:  Ji Young Jang; Hongjin Shim; Hye Youn Kwon; Hoejeong Chung; Pil Young Jung; Seongyup Kim; Hoon Ryu; Keum Seok Bae
Journal:  Eur J Trauma Emerg Surg       Date:  2017-12-27       Impact factor: 3.693

8.  The Role of Transcatheter Arterial Embolization in Traumatic Pelvic Hemorrhage: Not Only Pelvic Fracture.

Authors:  Alessio Comai; Marianna Zatelli; Thomas Haglmuller; Giampietro Bonatti
Journal:  Cureus       Date:  2016-08-03

9.  [Interventional emergency embolization for severe pelvic ring fractures with arterial bleeding. Integration into the early clinical treatment algorithm].

Authors:  J Westhoff; H Laurer; S Wutzler; H Wyen; M Mack; B Maier; I Marzi
Journal:  Unfallchirurg       Date:  2008-10       Impact factor: 1.000

Review 10.  Vertical shear pelvic injury: evaluation, management, and fixation strategies.

Authors:  Laura Blum; Mark E Hake; Ryan Charles; Todd Conlan; David Rojas; Murphy Trey Martin; Cyril Mauffrey
Journal:  Int Orthop       Date:  2018-03-26       Impact factor: 3.075

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