Forat Swaid1, Kobi Peleg2, Ricardo Alfici3, Oded Olsha4, Adi Givon5, Boris Kessel6. 1. General Surgery Department, Bnai-Zion Medical Center, Haifa, Israel. Electronic address: foratola@gmail.com. 2. National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel; Disaster Medicine Department, School of Public Health, Tel-Aviv University, Israel. 3. Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel. 4. Surgery Department, Shaare Zedek Medical Center, Jerusalem, Israel. 5. National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel. 6. Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel.
Abstract
PURPOSE: Pelvic fractures are a marker of severe injury, mandating a thorough investigation for the presence of associated injuries. Anatomical and physiological differences between adults and children may lead to a different impact of pelvic fractures on these populations. The purpose of this study is to compare pelvic fractures between pediatric and adult blunt trauma victims, mainly regarding their severity and associated intraabdominal injuries. METHODS: A retrospective study involving blunt trauma patients suffering pelvic fractures, according to the records of the Israeli National Trauma Registry. Patients included children, aged 0-14years, and adults between 15 and 64years. The presence and severity of associated injuries were assessed. RESULTS: Overall, 7621 patients aged 0-64years were identified with pelvic fractures following blunt trauma. The incidence of pelvic fractures in children was (0.8%), as compared to 4.3% in adults, p <0.0001. The most common mechanism of injury was motor vehicle accident (MVA) in adults, and pedestrian hit by car (PHBC) in children. About a quarter of the patients in both groups had an ISS >25. Adults sustained significantly more moderate to severe pelvic fractures (AIS≥3) than children (26.7% vs. 17.4%, p<0.0001). The overall mortality rate was similar among the two groups (5.4% in adults, 5.2% in children, p=0.7554). The only associated injury with statistically significant difference in incidence among the two groups was rectal injury (1.2% among children, 0.2% among adults, p<0.0001). Among adult patients, there was a clear correlation between the severity of pelvic fractures and the severity of concomitant splenic and hepatic injuries (p=0.026, p=0.0004, respectively). Among children, a similar correlation was not demonstrated. CONCLUSIONS: Adults involved in blunt trauma are more likely to sustain pelvic fractures, and these are generally more severe fractures, as compared to children suffering from blunt trauma. Nonetheless, mortality rates were found similar in both groups. The only associated injury with statistically significant difference in incidence among the two groups was rectal injury. In adults, but not in children, higher grade pelvic fractures correlated with more severe concomitant splenic or hepatic injuries. LEVEL OF EVIDENCE: The level of evidence for this study is III (3).
PURPOSE:Pelvic fractures are a marker of severe injury, mandating a thorough investigation for the presence of associated injuries. Anatomical and physiological differences between adults and children may lead to a different impact of pelvic fractures on these populations. The purpose of this study is to compare pelvic fractures between pediatric and adult blunt trauma victims, mainly regarding their severity and associated intraabdominal injuries. METHODS: A retrospective study involving blunt traumapatients suffering pelvic fractures, according to the records of the Israeli National Trauma Registry. Patients included children, aged 0-14years, and adults between 15 and 64years. The presence and severity of associated injuries were assessed. RESULTS: Overall, 7621 patients aged 0-64years were identified with pelvic fractures following blunt trauma. The incidence of pelvic fractures in children was (0.8%), as compared to 4.3% in adults, p <0.0001. The most common mechanism of injury was motor vehicle accident (MVA) in adults, and pedestrian hit by car (PHBC) in children. About a quarter of the patients in both groups had an ISS >25. Adults sustained significantly more moderate to severe pelvic fractures (AIS≥3) than children (26.7% vs. 17.4%, p<0.0001). The overall mortality rate was similar among the two groups (5.4% in adults, 5.2% in children, p=0.7554). The only associated injury with statistically significant difference in incidence among the two groups was rectal injury (1.2% among children, 0.2% among adults, p<0.0001). Among adult patients, there was a clear correlation between the severity of pelvic fractures and the severity of concomitant splenic and hepatic injuries (p=0.026, p=0.0004, respectively). Among children, a similar correlation was not demonstrated. CONCLUSIONS: Adults involved in blunt trauma are more likely to sustain pelvic fractures, and these are generally more severe fractures, as compared to children suffering from blunt trauma. Nonetheless, mortality rates were found similar in both groups. The only associated injury with statistically significant difference in incidence among the two groups was rectal injury. In adults, but not in children, higher grade pelvic fractures correlated with more severe concomitant splenic or hepatic injuries. LEVEL OF EVIDENCE: The level of evidence for this study is III (3).
Authors: Markus A Küper; Robert Bachmann; Götz F Wenig; Patrick Ziegler; Alexander Trulson; Inga M Trulson; Christian Minarski; Ruth Ladurner; Ulrich Stöckle; Andreas Höch; Steven C Herath; Fabian M Stuby Journal: World J Emerg Surg Date: 2020-01-17 Impact factor: 5.469
Authors: Shu-Hui Peng; Chun-Ying Huang; Shiun-Yuan Hsu; Li-Hui Yang; Ching-Hua Hsieh Journal: Int J Environ Res Public Health Date: 2018-04-25 Impact factor: 3.390