Pelvic fractures and mortality.

A retrospective study of all patients (N = 343) with pelvic fractures admitted to our trauma service was conducted to evaluate the impact of pelvic fractures on mortality. All patients sustained additional injuries with an average Injury Severity Score (ISS) of twenty. Thirty-six patients died. This group had more severe pelvic fractures as graded by the Tile classification as well as a greater number and severity of associated injuries. Six patients died as a direct result of pelvic hemorrhage. In six other patients, pelvic fractures contributed to their demise. The other twenty-four patients died from brain injury, thoracic hemorrhage, or other non-pelvic causes. Overall mortality for patients with pelvic fractures was 10.5 percent This was a 1.4 fold increase in mortality compared to other trauma patients during the same time period without pelvic fractures. Mortality was dramatically increased in patients over sixty years of age (37 percent mortality compared to 8 percent). This greater than four-fold increase in deaths in the elderly appears to be an age related effect because the elderly patients generally had a lower ISS and less severe pelvic trauma than younger patients. We conclude that sustaining a pelvic fracture places the patient at an increased risk of death. Pelvic fractures contributed directly to death in one-third of the mortalities, one-third died from complications associated with pelvic fractures, and one-third died from other causes.