Hao Wang1, J Laureano Phillips2, Richard D Robinson3, Therese M Duane2, Stefan Buca3, Mackenzie B Campbell-Furtick2, Adam Jennings3, Tyler Miller3, Nestor R Zenarosa3, Kathleen A Delaney3. 1. Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States. Electronic address: hwang01@jpshealth.org. 2. Department of Surgery, Research Institute, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States. 3. Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
Abstract
OBJECTIVES: Pelvic fractures are associated with increased risk of death among trauma patients. Studies show independent risks predicting mortality among patients with pelvic fractures vary across different geographic regions. This study analyses national data to determine predictors of mortality in initially stable adult pelvic trauma patients in the US. METHODS: This study is a retrospective analysis of the US National Trauma Data Bank from January 2003 to December 2010 among trauma patients ≥18 years of age with pelvic fractures (including acetabulum). Over 150 variables were reviewed and analysed. The primary outcome was all-cause in-hospital mortality. Logistic regression analysis was used to determine independent risk factors predictive of in-hospital mortality in stable pelvic fracture patients. RESULTS: 30,800 patients were included in the final analysis. Overall in-hospital mortality rate was 2.7%. Mortality increased twofold in middle aged patients (age 55-70), and increased nearly fourfold in patients with advanced age ≥70. We found patients with advanced age, higher severity of injury, Glasgow Coma Scale (GCS) <8, GCS between 9 and 12, prolonged mechanical ventilation, and/or in-hospital blood product administration experienced higher mortality. Patients transported to level 1 or level 2 trauma centres experienced lower mortality while concomitantly experiencing higher associated internal injuries. CONCLUSIONS: Geriatric and middle aged pelvic fracture patients experience higher mortality. Predictors of mortality in initially stable pelvic fracture patients are advanced age, injury severity, mental status, prolonged mechanical ventilation, and/or in-hospital blood product administration. These patients might benefit from transport to local level 1 or level 2 trauma centres.
OBJECTIVES:Pelvic fractures are associated with increased risk of death among traumapatients. Studies show independent risks predicting mortality among patients with pelvic fractures vary across different geographic regions. This study analyses national data to determine predictors of mortality in initially stable adult pelvic traumapatients in the US. METHODS: This study is a retrospective analysis of the US National Trauma Data Bank from January 2003 to December 2010 among traumapatients ≥18 years of age with pelvic fractures (including acetabulum). Over 150 variables were reviewed and analysed. The primary outcome was all-cause in-hospital mortality. Logistic regression analysis was used to determine independent risk factors predictive of in-hospital mortality in stable pelvic fracturepatients. RESULTS: 30,800 patients were included in the final analysis. Overall in-hospital mortality rate was 2.7%. Mortality increased twofold in middle aged patients (age 55-70), and increased nearly fourfold in patients with advanced age ≥70. We found patients with advanced age, higher severity of injury, Glasgow Coma Scale (GCS) <8, GCS between 9 and 12, prolonged mechanical ventilation, and/or in-hospital blood product administration experienced higher mortality. Patients transported to level 1 or level 2 trauma centres experienced lower mortality while concomitantly experiencing higher associated internal injuries. CONCLUSIONS: Geriatric and middle aged pelvic fracturepatients experience higher mortality. Predictors of mortality in initially stable pelvic fracturepatients are advanced age, injury severity, mental status, prolonged mechanical ventilation, and/or in-hospital blood product administration. These patients might benefit from transport to local level 1 or level 2 trauma centres.
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: Andreas Höch; Philipp Pieroh; Florian Gras; Tim Hohmann; Sven Märdian; Francis Holmenschlager; Holger Keil; Hans-Georg Palm; Steven C Herath; Christoph Josten; Hagen Schmal; Fabian M Stuby Journal: Int Orthop Date: 2019-04-04 Impact factor: 3.075
Authors: David R Tribble; Mary Ann Spott; Stacey A Shackleford; Jennifer M Gurney; Bg Clinton K Murray Journal: Mil Med Date: 2022-05-04 Impact factor: 1.563
Authors: Juan Antonio Llompart-Pou; Jon Pérez-Bárcena; Mario Chico-Fernández; Marcelino Sánchez-Casado; Joan Maria Raurich Journal: World J Crit Care Med Date: 2017-05-04
Authors: Hao Wang; Johnbosco Umejiego; Richard D Robinson; Chet D Schrader; JoAnna Leuck; Michael Barra; Stefan Buca; Andrew Shedd; Andrew Bui; Nestor R Zenarosa Journal: J Clin Med Res Date: 2016-07-01