The Effect of Pelvic Fracture on Mortality After Trauma: An Analysis of 63,000 Trauma Patients

• Published in: Journal of bone and joint surgery. American volume 2009-12, Vol.91 (12), p.2803-2810
• Main Authors: Sathy, Ashoke K, Starr, Adam J, Smith, Wade R, Elliott, Alan, Agudelo, Juan, Reinert, Charles M, Minei, Joseph P
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Diseases of the osteoarticular system; Fractures, Bone - mortality; Humans; Injuries of the limb. Injuries of the spine; Logistic Models; Medical sciences; Orthopedic surgery; Pelvic Bones - injuries; Registries; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Traumas. Diseases due to physical agents; Wounds and Injuries - mortality
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/JBJS.H.00598

BackgroundThe understanding of the mortality risk posed by pelvic fracture is incomplete. The purposes of this study were (1) to compare the mortality risk associated with a pelvic fracture with the risk conferred by other injuries and (2) to determine if the association of a pelvic fracture with mortality varies when combined with other known risk factors.MethodsTrauma registry records from two level-I trauma centers were examined. Regression analysis was done on 63,033 patients to assess the odds ratio for mortality associated with pelvic fracture compared with other variables such as age, shock, head injury, abdominal or chest injury, and extremity injury. A second analysis was carried out to determine if the impact of a pelvic fracture on mortality varied when combined with other known risk factors for mortality.ResultsLogistic regression analysis demonstrated that pelvic fracture was significantly associated with mortality (p < 0.001). The odds ratio for mortality associated with a pelvic fracture (approximately 2) was similar to that posed by an abdominal injury. Hemodynamic shock, severe head injury, and an age of sixty years or more all had an odds ratio for mortality greater than that associated with pelvic fracture.ConclusionsFor the majority of trauma patients, pelvic fracture is significantly associated with a greater risk of mortality. However, pelvic fracture is one variable among many that contribute to mortality risk, and it must be considered in relation to these other variables.Level of EvidencePrognostic Level II. See Instructions to Authors for a complete description of levels of evidence.