AIM: To determine the association of unstable pelvic ring injuries with trauma code status. METHODS: A retrospective review of all pelvic ring injuries at a single academic center from July 2010 to June 2013 was performed. The trauma registry was used to identify level 1 and level 2 trauma codes for each injury. The computed tomography scans in all patients were classified as stable or unstable using the Abbreviated Injury Scale. Pelvic injury classifications in level 1 and level 2 groups were compared. Patient disposition at discharge in level 1 and level 2 groups were also compared. RESULTS: There were 108 level 1 and 130 level 2 blunt trauma admissions. In the level 1 group, 67% of pelvic injuries were classified as stable fracture patterns and 33% were classified as unstable. In the level 2 group, 62% of pelvic injuries were classified as stable fracture patterns and 38% were classified as unstable. level 1 trauma code was not associated with odds of having an unstable fracture pattern (OR = 0.83, 95%CI: 0.48-1.41, P = 0.485). In the level 1 group with unstable pelvic injuries, 33% were discharged to home, 36% to a rehabilitation facility, and 32% died. In the level 2 group with unstable pelvic injuries, 65% were discharged to home, 31% to a rehabilitation facility, and 4% died. For those with unstable pelvic fractures (n = 85), assignment of a level 2 trauma code was associated with reduced odds of death (OR = 0.07, 95%CI: 0.01-0.35, P = 0.001) as compared to being discharged to home. CONCLUSION: Trauma code level assignment is not correlated with severity of pelvic injury. Because an unstable pelvis can lead to hemodynamic instability, these injuries may be undertriaged.
AIM: To determine the association of unstable pelvic ring injuries with trauma code status. METHODS: A retrospective review of all pelvic ring injuries at a single academic center from July 2010 to June 2013 was performed. The trauma registry was used to identify level 1 and level 2 trauma codes for each injury. The computed tomography scans in all patients were classified as stable or unstable using the Abbreviated Injury Scale. Pelvic injury classifications in level 1 and level 2 groups were compared. Patient disposition at discharge in level 1 and level 2 groups were also compared. RESULTS: There were 108 level 1 and 130 level 2 blunt trauma admissions. In the level 1 group, 67% of pelvic injuries were classified as stable fracture patterns and 33% were classified as unstable. In the level 2 group, 62% of pelvic injuries were classified as stable fracture patterns and 38% were classified as unstable. level 1 trauma code was not associated with odds of having an unstable fracture pattern (OR = 0.83, 95%CI: 0.48-1.41, P = 0.485). In the level 1 group with unstable pelvic injuries, 33% were discharged to home, 36% to a rehabilitation facility, and 32% died. In the level 2 group with unstable pelvic injuries, 65% were discharged to home, 31% to a rehabilitation facility, and 4% died. For those with unstable pelvic fractures (n = 85), assignment of a level 2 trauma code was associated with reduced odds of death (OR = 0.07, 95%CI: 0.01-0.35, P = 0.001) as compared to being discharged to home. CONCLUSION:Trauma code level assignment is not correlated with severity of pelvic injury. Because an unstable pelvis can lead to hemodynamic instability, these injuries may be undertriaged.
Authors: Kjetil G Ringdal; Nils Oddvar Skaga; Morten Hestnes; Petter Andreas Steen; Jo Røislien; Marius Rehn; Olav Røise; Andreas J Krüger; Hans Morten Lossius Journal: Injury Date: 2012-07-24 Impact factor: 2.586
Authors: Roberto de Moraes Cordts Filho; José Gustavo Parreira; Jaqueline A Giannini Perlingeiro; Silvia C Soldá; Tércio de Campos; José Cesar Assef Journal: Rev Col Bras Cir Date: 2011 Sep-Oct
Authors: B J Gabbe; M Esser; A Bucknill; M K Russ; D-J Hofstee; P A Cameron; C Handley; R N de Steiger Journal: Bone Joint J Date: 2013-10 Impact factor: 5.082
Authors: Gil Z Shlamovitz; William R Mower; Jonathan Bergman; Kenneth R Chuang; Jonathan Crisp; David Hardy; Martine Sargent; Sunil D Shroff; Eric Snyder; Marshall T Morgan Journal: J Trauma Date: 2009-03