BACKGROUND: The severity of pelvic ring fractures (PRFs) can range from minor injury with low-energy mechanism to high-energy injury causing prehospital death. The purpose of this study was to prospectively describe the comprehensive pelvic fracture occurrence in an inclusive trauma system. METHODS: A 12-month prospective, population-based epidemiologic study was performed in the Hunter Region, New South Wales, Australia (population of 600,000, served by one Level I trauma center and 7 referring hospitals). Patient demographics, mechanism, injury severity, shock parameters, and outcomes were recorded prospectively. The database included all pelvic fractures from the region: high-energy pelvic fractures (HE-PRFs), low-energy pelvic fractures (LE-PRFs), and prehospital deaths (PD-PRFs). RESULTS: The incidence of PRF in the trauma system was 23 per 100,000 persons (138 fractures). The incidences of HE-PRF and LE-PRF were each 10 per 100,000 persons, whereas there were 3 PD-PRFs per 100,000. HE-PRF compared with LE-PRF occurred predominantly in men (64% vs. 20%, p < 0.05), younger persons (41 +/- 3 vs. 83 +/- 1 years, p < 0.05), those who had a higher Injury Severity Score (23 +/- 3 vs. 6 +/- 1, p < 0.05), and those with lower blood pressure (111 +/- 1 mm Hg vs. 153 +/- 1 mm Hg, p < 0.05), but the inhospital mortality rate was not statistically different (15% vs. 8%, p = NS). The overall mortality of the cohort was 23% (60% of those were from the PD-PRF group). The PRF-related mortality was 7% (HE-PRF: 7%; LE-PRF: 2%; PD-PRF: 33%), which was always attributable to bleeding. The incidence of demonstrated pelvic fracture-related arterial bleeding was 1.3 per 100,000 persons per year. CONCLUSIONS: LE-PRF and HE-PRF are equally frequent among hospital admissions. They represent two distinct demographic groups with similar mortality rate. Most PRF-related deaths occur prehospitally. Bleeding remains the primary cause of PRF-related mortality in all groups.
BACKGROUND: The severity of pelvic ring fractures (PRFs) can range from minor injury with low-energy mechanism to high-energy injury causing prehospital death. The purpose of this study was to prospectively describe the comprehensive pelvic fracture occurrence in an inclusive trauma system. METHODS: A 12-month prospective, population-based epidemiologic study was performed in the Hunter Region, New South Wales, Australia (population of 600,000, served by one Level I trauma center and 7 referring hospitals). Patient demographics, mechanism, injury severity, shock parameters, and outcomes were recorded prospectively. The database included all pelvic fractures from the region: high-energy pelvic fractures (HE-PRFs), low-energy pelvic fractures (LE-PRFs), and prehospital deaths (PD-PRFs). RESULTS: The incidence of PRF in the trauma system was 23 per 100,000 persons (138 fractures). The incidences of HE-PRF and LE-PRF were each 10 per 100,000 persons, whereas there were 3 PD-PRFs per 100,000. HE-PRF compared with LE-PRF occurred predominantly in men (64% vs. 20%, p < 0.05), younger persons (41 +/- 3 vs. 83 +/- 1 years, p < 0.05), those who had a higher Injury Severity Score (23 +/- 3 vs. 6 +/- 1, p < 0.05), and those with lower blood pressure (111 +/- 1 mm Hg vs. 153 +/- 1 mm Hg, p < 0.05), but the inhospital mortality rate was not statistically different (15% vs. 8%, p = NS). The overall mortality of the cohort was 23% (60% of those were from the PD-PRF group). The PRF-related mortality was 7% (HE-PRF: 7%; LE-PRF: 2%; PD-PRF: 33%), which was always attributable to bleeding. The incidence of demonstrated pelvic fracture-related arterial bleeding was 1.3 per 100,000 persons per year. CONCLUSIONS: LE-PRF and HE-PRF are equally frequent among hospital admissions. They represent two distinct demographic groups with similar mortality rate. Most PRF-related deaths occur prehospitally. Bleeding remains the primary cause of PRF-related mortality in all groups.
Authors: Amr Eisa; Osama Farouk; Dalia G Mahran; Mahmoud Badran; Mohammad K Abdelnasser; Michael Samir; Vasiliki Kalampoki; Anahi Hurtado-Chong; Elke Rometsch; Aly Mohamedean; Faisal Adam Journal: Int Orthop Date: 2018-12-04 Impact factor: 3.075
Authors: Nikolaos K Kanakaris; Tess Greven; Robert M West; Arie B Van Vugt; Peter V Giannoudis Journal: Int Orthop Date: 2017-07-21 Impact factor: 3.075
Authors: Diederik O F Verbeek; Ijsbrand A J Zijlstra; Christaan van der Leij; Kornelis J Ponsen; Otto M van Delden; J Carel Goslings Journal: World J Surg Date: 2014-07 Impact factor: 3.352
Authors: K Rapp; I D Cameron; S Kurrle; J Klenk; A Kleiner; S Heinrich; H-H König; C Becker Journal: Osteoporos Int Date: 2010-01-08 Impact factor: 4.507
Authors: Richard Martin Sellei; Peter Schandelmaier; Philipp Kobbe; Matthias Knobe; Hans-Christoph Pape Journal: Clin Orthop Relat Res Date: 2013-09 Impact factor: 4.176