Patients with pelvic fractures from blunt trauma. What is the cause of mortality and when?

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• 作者：Rahul Vaidya ; M.D. ; F.R.C.Sc. ; ^{rahvaidya2012@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Alesha N. Scott ; D.O. ; Fred Tonnos ; D.O. ; Ian Hudson ; D.O. ; M.P.H. ; Adam J. Martin ; B.S. ; Anil Sethi ; M.D.
• 关键词：Pelvic fracture ; Mortality ; Survival time
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：211
• 期：3
• 页码：495-500
• 全文大小：422 K

文摘

Mortality in patients sustaining pelvic fractures has been reported to be 4% to 15%. We sought to investigate the cause of death based on timing and evaluate if type of fracture and Injury Severity Score have an influence on the survival time.

Methods

Sixty-nine patients of eight hundred sixty seven with a pelvic fracture who died during their hospital admission were included. Fractures were classified using the Arbeitsgemeinschaft Osteosynthesefragen/Orthopaedic Trauma Association system. Cause determined by autopsy in 48/69.

Results

The leading cause of death within 6 hours was abdominal and pelvic hemorrhage; 6 to 24 hours head injury, and greater than 24 hours multiple organ dysfunction syndrome. Survival time did not correlate between fracture type (P < .12) or Injury Severity Score. Only 2 patients died of isolated pelvic hemorrhage.

Conclusions

Despite the advances made in acute management of the traumatized patient in the emergency department, mortality is unavoidable in a small group of patients with hemorrhage being the commonest cause of early death but isolated pelvic hemorrhage rare.