Abstract
BackgroundTraumatic pelvic fracture (TPF) is a significant injury that results from high energy impact and has a high morbidity and mortality.PurposeWe aimed to describe the epidemiology, incidence, patterns, management, and outcomes of TPF in multinational level 1 trauma centers.MethodsWe conducted a retrospective analysis of all patients with TPF between 2010 and 2016 at two trauma centers in Qatar and Germany.ResultsA total of 2112 patients presented with traumatic pelvic injuries, of which 1814 (85.9%) sustained TPF, males dominated (76.5%) with a mean age of 41 ± 21 years. In unstable pelvic fracture, the frequent mechanism of injury was motor vehicle crash (41%) followed by falls (35%) and pedestrian hit by vehicle (24%). Apart from both extremities, the chest (37.3%) was the most commonly associated injured region. The mean injury severity score (ISS) of 16.5 ± 13.3. Hemodynamic instability was observed in 44%. Blood transfusion was needed in one third while massive transfusion and intensive care admission were required in a tenth and a quarter of cases, respectively. Tile classification was possible in 1228 patients (type A in 60%, B in 30%, and C in 10%). Patients with type C fractures had higher rates of associated injuries, higher ISS, greater pelvis abbreviated injury score (AIS), massive transfusion protocol activation, prolonged hospital stay, complications, and mortality (p value < 0.001). Two-thirds of patients were managed conservatively while a third needed surgical fixation. The median length of hospital and intensive care stays were 15 and 5 days, respectively. The overall mortality rate was 4.7% (86 patients).ConclusionTPF is a common injury among polytrauma patients. It needs a careful, systematic management approach to address the associated complexities and the polytrauma nature.
Highlights
In polytrauma patients, pelvic injuries are commonly seen
Data analysis was carried out using the Statistical Package for the Social Sciences, version 18 (SPSS, Inc, Chicago, IL). This was a retrospective observational study for cases of pelvic fracture admitted to two participating centers between January 2010 and June 2016
We identified 2112 patients who sustained traumatic pelvic injuries, of which 1814 (86%) had traumatic pelvic fractures
Summary
Injury to pelvic region accounts for 10% of all the blunt trauma admissions [1]. The clinical presentation and outcomes of pelvic fractures depend on the hemodynamic status. Managing these injuries is challenging both from the diagnostic and therapeutic perspectives, especially in unstable patients. Young men are more susceptible to the highenergy traumatic injuries [3]. Such high-energy mechanisms are most commonly associated with pelvic fractures, but still, low-energy trauma may lead to a fracture in some patients, among the elderly [5, 6]. Purpose: We aimed to describe the epidemiology, incidence, patterns, management, and outcomes of TPF in multinational level 1 trauma centers
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