Concomitant external and internal hemorrhage: Challenges to managing patients with open pelvic fracture

Managing patients with open pelvic fractures continues to be challenging and requires a multidisciplinary approach. In this study, we examined the characteristics of patients with open pelvic fractures and strategies for managing such patients. The records of patients with open pelvic fractures from...

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Bibliographic Details
Published in:The American journal of emergency medicine 2018-11, Vol.36 (11), p.1937-1942
Main Authors: Fu, Chih-Yuan, Huang, Ruo-Yi, Wang, Shang-Yu, Liao, Chien-Hung, Huang, Jen-Fu, Hsu, Yu-Pao, Lin, Chia-Yun, Kang, Shih-Ching
Format: Article
Language:English
Subjects:
Abdomen
Age
Blood pressure
Blood transfusions
Classification
Embolization
Emergency medical care
External hemorrhage
Fatalities
Fractures
Hemorrhage
Hemostasis
Hemostatics
Injuries
Intensive care
Internal hemorrhage
Medical prognosis
Mortality
Multiple organ dysfunction syndrome
Open pelvic fracture
Ostomy
Patients
Sepsis
Surgeons
Surgery
Trauma
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Summary:Managing patients with open pelvic fractures continues to be challenging and requires a multidisciplinary approach. In this study, we examined the characteristics of patients with open pelvic fractures and strategies for managing such patients. The records of patients with open pelvic fractures from January 2010 to August 2016 were retrospectively reviewed. Emergency surgery was performed to control hemorrhaging in patients with an active external hemorrhage. Transcatheter arterial embolization (TAE) was used for definitive hemostasis. The relation between cause of death and timing of death was examined. We also compared the characteristics of surviving and non-surviving patients. Furthermore, patients who received both surgery and post-operative TAE were analyzed in detail. In total, 42 patients with open pelvic fractures were enrolled in the study. The overall mortality rate among patients with open pelvic fractures was 26.2%. Patients whose deaths were related to hemorrhaging and associated injuries died significantly earlier than patients whose deaths were related to sepsis and multiple organ failure (1.3days vs. 12.3days, p
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2018.02.014