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

Abstract Background 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...

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Bibliographic Details
Published in:The American journal of surgery 2016-03, Vol.211 (3), p.495-500
Main Authors: Vaidya, Rahul, M.D., F.R.C.Sc, Scott, Alesha N., D.O, Tonnos, Fred, D.O, Hudson, Ian, D.O., M.P.H, Martin, Adam J., B.S, Sethi, Anil, M.D
Format: Article
Language:English
Subjects:
Abdomen
Adolescent
Adult
Age
Aged
Aged, 80 and over
Blood products
Blood transfusions
Bone surgery
Cause of Death
Classification
Female
Fractures, Bone - etiology
Fractures, Bone - mortality
Fractures, Bone - therapy
Head injuries
Humans
Injury Severity Score
Intensive care
Male
Methods
Middle Aged
Mortality
Pelvic Bones - injuries
Pelvic fracture
Respiratory distress syndrome
Risk Factors
Studies
Surgery
Survival Rate
Survival time
Trauma
Trauma centers
Wounds, Nonpenetrating - complications
Wounds, Nonpenetrating - mortality
Wounds, Nonpenetrating - therapy
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Summary:Abstract Background 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.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.08.038