Prevalence of pelvic fractures, associated injuries, and mortality: The United Kingdom perspective

被引:196
作者
Giannoudis, Peter V.
Grotz, Martin R. W.
Tzioupis, Christopher
Dinopoulos, Haralambos
Wells, Gareth E.
Bouamra, Otmar
Lecky, Fiona
机构
[1] Univ Leeds, Gen Infirm, Dept Orthopaed & Trauma, Leeds LS1 3EX, W Yorkshire, England
[2] Univ Manchester, Hope Hosp, Trauma Audit and Res Network, Salford M6 8HD, Lancs, England
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2007年 / 63卷 / 04期
关键词
pelvic fractures; prevalence; UK perspective;
D O I
10.1097/01.ta.0000242259.67486.15
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facilities in the receiving hospitals on outcome. Methods: Prospective data from 106 trauma receiving hospitals forming the Trauma Audit and Research Network were studied. Between January 1989 and December 2001 data of 159,746 trauma patients were collected in the Trauma Audit and Research Network database. Because of incomplete data, 1,610 pelvic fracture patients and 13,499 patients with-out pelvic fracture were excluded from detailed analysis. In total, 11,149 patients in the PG and the remaining 133,486 patients in the NPG (control) group were included in the final analysis. Results: There were statistically significantly more patients with an Injury Severity Score > 15 in the PG group (n = 3,576; 32.1%) than in NPG group (n = 19,238; 14.4%) (p < 0.001), indicating that pelvic injuries were more often associated with other injuries. The majority of patients sustained Abbreviated Injury Score (AIS) 2 pelvic injuries (65.0%), whereas AIS 4 and 5 injuries were found in less than 10% of patients. Pelvic ring injuries were most commonly associated with chest trauma with >AIS 2 severity in 21.2% of the patients, head injuries (> AIS 2) in 16.9%, liver or spleen injuries in 8.0%, and two or more long bone fractures in 7.8%. The 3-month cumulative mortality rate of the patients with pelvic injuries was 14.2% (1,586 patients) versus 5.6% (7,465 patients) of the NPG group. Conclusion: Age, early physiologic derangement, and presence of other injuries (head or trunk) were associated with reduced survival rates. When the expertise to deal with such a group of patients is not available, early transfer under safe conditions should be considered to improve survival rates.
引用
收藏
页码:875 / 883
页数:9
相关论文
共 57 条
[1]   Pelvic trauma in rapidly fatal motor vehicle accidents [J].
Adams, JE ;
Davis, GG ;
Alexander, CB ;
Alonso, JE .
JOURNAL OF ORTHOPAEDIC TRAUMA, 2003, 17 (06) :406-410
[2]   Analysis of the incidence of pelvic trauma in fatal automobile accidents [J].
Adams, JE ;
Davis, GG ;
Heidepriem, RW ;
Alonso, JE ;
Alexander, CB .
AMERICAN JOURNAL OF FORENSIC MEDICINE AND PATHOLOGY, 2002, 23 (02) :132-136
[3]  
Allen CF, 2000, AM SURGEON, V66, P735
[4]   Profile of geriatric pelvic fractures presenting to the emergency department [J].
Alost, T ;
Waldrop, RD .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1997, 15 (06) :576-578
[5]  
[Anonymous], ABBR INJ SCAL AIS
[6]   INJURY SEVERITY SCORE - UPDATE [J].
BAKER, SP ;
ONEILL, B .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1976, 16 (11) :882-885
[7]   INJURY SEVERITY SCORE - METHOD FOR DESCRIBING PATIENTS WITH MULTIPLE INJURIES AND EVALUATING EMERGENCY CARE [J].
BAKER, SP ;
ONEILL, B ;
HADDON, W ;
LONG, WB .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1974, 14 (03) :187-196
[8]   Impact of helicopter transport and hospital level on mortality of polytrauma patients [J].
Biewener, A ;
Aschenbrenner, U ;
Rammelt, S ;
Grass, R ;
Zwipp, H .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2004, 56 (01) :94-98
[9]   Pelvic trauma management within the UK: a reflection of a failing trauma service [J].
Bircher, M ;
Giannoudis, PV .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2004, 35 (01) :2-6
[10]   Long-term outcomes in open pelvic fractures [J].
Brenneman, FD ;
Katyal, D ;
Boulanger, BR ;
Tile, M ;
Redelmeier, DA .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1997, 42 (05) :773-777