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Profile of geriatric pelvic fractures presenting to the emergency department
Few studies have examined differences in mechanism, presentation, and outcome of trauma in geriatric patients. This study compared pelvic fractures and associated injuries in geriatric and nongeriatric patients. The medical charts of all patients presenting to a large urban emergency medicine teachi...
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Published in: | The American journal of emergency medicine 1997-10, Vol.15 (6), p.576-578 |
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description | Few studies have examined differences in mechanism, presentation, and outcome of trauma in geriatric patients. This study compared pelvic fractures and associated injuries in geriatric and nongeriatric patients. The medical charts of all patients presenting to a large urban emergency medicine teaching program with a pelvic fracture between January 1, 1987 and December 31, 1993 were retrospectively reviewed by study-blinded physicians. Data collected included mechanism and site of injury, associated injuries, disposition (admission or discharge), need for operative repair, length of hospital stay, as well as subsequent deaths and causes. The data were stratified into patients less than 65 years of age (group A) and 65 years or older (group B). Two-hundred five pelvic fractures were reviewed with 85 (41%) in group B. A significantly greater number of pelvic fractures in group B occurred by fall (86%
v 25%,
P < .05) and significantly less by motor vehicle accident (14%
v 75%,
P < .05). Site of pelvic fracture differed significantly only in the decreased number of geriatric iliac fractures (6%
v 16%,
P < .05). The sites of pelvic fractures for geriatric patients in descending order were multiple sites (58%), public rami (56%), acetabulum (19%), ischium (11%), iliac (6%), and sacroiliac (2%), and did not differ from nongeriatric patients. Geriatric patients had significantly fewer total associated injuries (40%
v 61%,
P < .05) although associated chest injuries were significantly more common (21%
v 8%,
P < .05). Death occurred in three (3%) nongeriatric and nine (11%) geriatric patients. Six geriatric deaths were caused by exacerbation of underlying cardiovascular disease. Geriatric patients underwent significantly fewer operative procedures (6%
v 43%,
P < .05) but there were no significant differences in the percent admitted (85%) or mean length of hospital stay (9.59 days). Despite the decreased severity of pelvic fractures, care must be taken to prevent morbidity caused by exacerbation of premorbid illnesses in geriatric patients with pelvic fractures. |
doi_str_mv | 10.1016/S0735-6757(97)90161-3 |
format | article |
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v 25%,
P < .05) and significantly less by motor vehicle accident (14%
v 75%,
P < .05). Site of pelvic fracture differed significantly only in the decreased number of geriatric iliac fractures (6%
v 16%,
P < .05). The sites of pelvic fractures for geriatric patients in descending order were multiple sites (58%), public rami (56%), acetabulum (19%), ischium (11%), iliac (6%), and sacroiliac (2%), and did not differ from nongeriatric patients. Geriatric patients had significantly fewer total associated injuries (40%
v 61%,
P < .05) although associated chest injuries were significantly more common (21%
v 8%,
P < .05). Death occurred in three (3%) nongeriatric and nine (11%) geriatric patients. Six geriatric deaths were caused by exacerbation of underlying cardiovascular disease. Geriatric patients underwent significantly fewer operative procedures (6%
v 43%,
P < .05) but there were no significant differences in the percent admitted (85%) or mean length of hospital stay (9.59 days). Despite the decreased severity of pelvic fractures, care must be taken to prevent morbidity caused by exacerbation of premorbid illnesses in geriatric patients with pelvic fractures.]]></description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/S0735-6757(97)90161-3</identifier><identifier>PMID: 9337365</identifier><identifier>CODEN: AJEMEN</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Accidental Falls ; Accidents, Traffic ; Aged ; Biological and medical sciences ; Biomechanical Phenomena ; emergency department ; Emergency Service, Hospital ; Fractures, Bone - classification ; Fractures, Bone - etiology ; Fractures, Bone - therapy ; geriatric ; Hospital Mortality ; Humans ; Injuries of the limb. Injuries of the spine ; Length of Stay ; Medical sciences ; Middle Aged ; Multiple Trauma - etiology ; Multiple Trauma - therapy ; Pelvic Bones - injuries ; Pelvic fracture ; Retrospective Studies ; Traumas. Diseases due to physical agents ; Treatment Outcome</subject><ispartof>The American journal of emergency medicine, 1997-10, Vol.15 (6), p.576-578</ispartof><rights>1997</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-bb408961ba62c59666dd3c31355109d9c8bbe1839fde8f9839c73b8984c29b9f3</citedby><cites>FETCH-LOGICAL-c389t-bb408961ba62c59666dd3c31355109d9c8bbe1839fde8f9839c73b8984c29b9f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2069576$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9337365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alost, Terence</creatorcontrib><creatorcontrib>Waldrop, Ron D</creatorcontrib><title>Profile of geriatric pelvic fractures presenting to the emergency department</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description><![CDATA[Few studies have examined differences in mechanism, presentation, and outcome of trauma in geriatric patients. This study compared pelvic fractures and associated injuries in geriatric and nongeriatric patients. The medical charts of all patients presenting to a large urban emergency medicine teaching program with a pelvic fracture between January 1, 1987 and December 31, 1993 were retrospectively reviewed by study-blinded physicians. Data collected included mechanism and site of injury, associated injuries, disposition (admission or discharge), need for operative repair, length of hospital stay, as well as subsequent deaths and causes. The data were stratified into patients less than 65 years of age (group A) and 65 years or older (group B). Two-hundred five pelvic fractures were reviewed with 85 (41%) in group B. A significantly greater number of pelvic fractures in group B occurred by fall (86%
v 25%,
P < .05) and significantly less by motor vehicle accident (14%
v 75%,
P < .05). Site of pelvic fracture differed significantly only in the decreased number of geriatric iliac fractures (6%
v 16%,
P < .05). The sites of pelvic fractures for geriatric patients in descending order were multiple sites (58%), public rami (56%), acetabulum (19%), ischium (11%), iliac (6%), and sacroiliac (2%), and did not differ from nongeriatric patients. Geriatric patients had significantly fewer total associated injuries (40%
v 61%,
P < .05) although associated chest injuries were significantly more common (21%
v 8%,
P < .05). Death occurred in three (3%) nongeriatric and nine (11%) geriatric patients. Six geriatric deaths were caused by exacerbation of underlying cardiovascular disease. Geriatric patients underwent significantly fewer operative procedures (6%
v 43%,
P < .05) but there were no significant differences in the percent admitted (85%) or mean length of hospital stay (9.59 days). Despite the decreased severity of pelvic fractures, care must be taken to prevent morbidity caused by exacerbation of premorbid illnesses in geriatric patients with pelvic fractures.]]></description><subject>Accidental Falls</subject><subject>Accidents, Traffic</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>emergency department</subject><subject>Emergency Service, Hospital</subject><subject>Fractures, Bone - classification</subject><subject>Fractures, Bone - etiology</subject><subject>Fractures, Bone - therapy</subject><subject>geriatric</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Length of Stay</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multiple Trauma - etiology</subject><subject>Multiple Trauma - therapy</subject><subject>Pelvic Bones - injuries</subject><subject>Pelvic fracture</subject><subject>Retrospective Studies</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><recordid>eNqFkF1LwzAUhoMoc05_gtALEb2oJk2TNFciwy8YKKjXIU1PZ6RfJulg_97Mjd0KISfkfc5JeBA6J_iGYMJv37GgLOWCiSsprmW8Iik9QFPCaJYWRJBDNN0jx-jE-2-MCclZPkETSamgnE3R4s31tW0g6etkCc7q4KxJBmhWsdROmzA68MkQN-iC7ZZJ6JPwBQm04JbQmXVSwaBdaGN8io5q3Xg429UZ-nx8-Jg_p4vXp5f5_SI1tJAhLcscF5KTUvPMMMk5rypqKKGMESwraYqyBFJQWVdQ1DIejKBlIYvcZLKUNZ2hy-3cwfU_I_igWusNNI3uoB-9EpLmDFMWQbYFjeu9d1CrwdlWu7UiWG0sqj-LaqNIybg2FhWNfee7B8ayhWrftdMW84tdrr3RTfTUGev3WIa5ZIJH7G6LQZSxsuCUNzY6g8o6MEFVvf3nI78eB47C</recordid><startdate>19971001</startdate><enddate>19971001</enddate><creator>Alost, Terence</creator><creator>Waldrop, Ron D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19971001</creationdate><title>Profile of geriatric pelvic fractures presenting to the emergency department</title><author>Alost, Terence ; Waldrop, Ron D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-bb408961ba62c59666dd3c31355109d9c8bbe1839fde8f9839c73b8984c29b9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Accidental Falls</topic><topic>Accidents, Traffic</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomechanical Phenomena</topic><topic>emergency department</topic><topic>Emergency Service, Hospital</topic><topic>Fractures, Bone - classification</topic><topic>Fractures, Bone - etiology</topic><topic>Fractures, Bone - therapy</topic><topic>geriatric</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Length of Stay</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multiple Trauma - etiology</topic><topic>Multiple Trauma - therapy</topic><topic>Pelvic Bones - injuries</topic><topic>Pelvic fracture</topic><topic>Retrospective Studies</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alost, Terence</creatorcontrib><creatorcontrib>Waldrop, Ron D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alost, Terence</au><au>Waldrop, Ron D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Profile of geriatric pelvic fractures presenting to the emergency department</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>1997-10-01</date><risdate>1997</risdate><volume>15</volume><issue>6</issue><spage>576</spage><epage>578</epage><pages>576-578</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><coden>AJEMEN</coden><abstract><![CDATA[Few studies have examined differences in mechanism, presentation, and outcome of trauma in geriatric patients. This study compared pelvic fractures and associated injuries in geriatric and nongeriatric patients. The medical charts of all patients presenting to a large urban emergency medicine teaching program with a pelvic fracture between January 1, 1987 and December 31, 1993 were retrospectively reviewed by study-blinded physicians. Data collected included mechanism and site of injury, associated injuries, disposition (admission or discharge), need for operative repair, length of hospital stay, as well as subsequent deaths and causes. The data were stratified into patients less than 65 years of age (group A) and 65 years or older (group B). Two-hundred five pelvic fractures were reviewed with 85 (41%) in group B. A significantly greater number of pelvic fractures in group B occurred by fall (86%
v 25%,
P < .05) and significantly less by motor vehicle accident (14%
v 75%,
P < .05). Site of pelvic fracture differed significantly only in the decreased number of geriatric iliac fractures (6%
v 16%,
P < .05). The sites of pelvic fractures for geriatric patients in descending order were multiple sites (58%), public rami (56%), acetabulum (19%), ischium (11%), iliac (6%), and sacroiliac (2%), and did not differ from nongeriatric patients. Geriatric patients had significantly fewer total associated injuries (40%
v 61%,
P < .05) although associated chest injuries were significantly more common (21%
v 8%,
P < .05). Death occurred in three (3%) nongeriatric and nine (11%) geriatric patients. Six geriatric deaths were caused by exacerbation of underlying cardiovascular disease. Geriatric patients underwent significantly fewer operative procedures (6%
v 43%,
P < .05) but there were no significant differences in the percent admitted (85%) or mean length of hospital stay (9.59 days). Despite the decreased severity of pelvic fractures, care must be taken to prevent morbidity caused by exacerbation of premorbid illnesses in geriatric patients with pelvic fractures.]]></abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>9337365</pmid><doi>10.1016/S0735-6757(97)90161-3</doi><tpages>3</tpages></addata></record> |
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subjects | Accidental Falls Accidents, Traffic Aged Biological and medical sciences Biomechanical Phenomena emergency department Emergency Service, Hospital Fractures, Bone - classification Fractures, Bone - etiology Fractures, Bone - therapy geriatric Hospital Mortality Humans Injuries of the limb. Injuries of the spine Length of Stay Medical sciences Middle Aged Multiple Trauma - etiology Multiple Trauma - therapy Pelvic Bones - injuries Pelvic fracture Retrospective Studies Traumas. Diseases due to physical agents Treatment Outcome |
title | Profile of geriatric pelvic fractures presenting to the emergency department |
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