TY - JOUR
T1 - Predictors of mortality following severe pelvic ring fracture: Results of a population-based study
AU - Gabbe, Belinda
AU - de Steiger, Richard Noel
AU - Esser, Max
AU - Bucknill, Andrew
AU - Russ, Matthias
AU - Cameron, Peter
PY - 2011
Y1 - 2011
N2 - Introduction: Traumatic disruption of the pelvic ring is uncommon but is associated with a high risk of
mortality. These injuries are predominantly due to high energy blunt trauma such as a fall from height,
road or workplace trauma, and severe associated injuries are prevalent, increasing the complexity of
managing this patient group. The aim of this population-based study was to investigate predictors of
mortality following severe pelvic ring fractures managed in an inclusive, regionalised trauma system.
Methods: Cases aged 15 years from 1st July 2001 to 30th June 2008 were extracted from the
population-based statewide Victorian State Trauma Registry for analysis. Patient demographic,
prehospital and admission characteristics were considered as potential predictors of mortality.
Multivariate logistic regression was used to identify predictors of mortality with adjusted odds ratios
(AOR) and 95 confidence intervals (CI) calculated.
Results: There were 348 cases over the 8-year period. The mortality rate was 19 . Patients aged 65
years were at higher odds of mortality (AOR 7.6, 95 CI: 2.8, 20.4) than patients aged 15a??34 years.
Patients hypotensive at the scene (AOR 5.5, 95 CI: 2.3, 13.2), and on arrival at the definitive hospital of
care (AOR 3.7, 955 CI: 1.7, 8.0), were more likely to die than patients without hypotension. The presence
of a severe chest injury was associated with an increased odds of mortality (AOR 2.8, 95 CI: 1.3, 6.1),
whilst patients injured in intentional events were also more likely to die than patients involved in
unintentional events (AOR 4.9, 95 CI: 1.6, 15.6). There was no association between the hospital of
definitive management and mortality after adjustment for other variables, despite differences in the
protocols for managing these patients at the major trauma services (Level 1 trauma centres).
Conclusions: The findings highlight the importance of effective control of haemodynamic instability for
reducing the risk of mortality. As most patients survive these injuries, further research should focus on
long term morbidity and the impact of different treatment approaches.
AB - Introduction: Traumatic disruption of the pelvic ring is uncommon but is associated with a high risk of
mortality. These injuries are predominantly due to high energy blunt trauma such as a fall from height,
road or workplace trauma, and severe associated injuries are prevalent, increasing the complexity of
managing this patient group. The aim of this population-based study was to investigate predictors of
mortality following severe pelvic ring fractures managed in an inclusive, regionalised trauma system.
Methods: Cases aged 15 years from 1st July 2001 to 30th June 2008 were extracted from the
population-based statewide Victorian State Trauma Registry for analysis. Patient demographic,
prehospital and admission characteristics were considered as potential predictors of mortality.
Multivariate logistic regression was used to identify predictors of mortality with adjusted odds ratios
(AOR) and 95 confidence intervals (CI) calculated.
Results: There were 348 cases over the 8-year period. The mortality rate was 19 . Patients aged 65
years were at higher odds of mortality (AOR 7.6, 95 CI: 2.8, 20.4) than patients aged 15a??34 years.
Patients hypotensive at the scene (AOR 5.5, 95 CI: 2.3, 13.2), and on arrival at the definitive hospital of
care (AOR 3.7, 955 CI: 1.7, 8.0), were more likely to die than patients without hypotension. The presence
of a severe chest injury was associated with an increased odds of mortality (AOR 2.8, 95 CI: 1.3, 6.1),
whilst patients injured in intentional events were also more likely to die than patients involved in
unintentional events (AOR 4.9, 95 CI: 1.6, 15.6). There was no association between the hospital of
definitive management and mortality after adjustment for other variables, despite differences in the
protocols for managing these patients at the major trauma services (Level 1 trauma centres).
Conclusions: The findings highlight the importance of effective control of haemodynamic instability for
reducing the risk of mortality. As most patients survive these injuries, further research should focus on
long term morbidity and the impact of different treatment approaches.
UR - http://www.ncbi.nlm.nih.gov/pubmed/21733513
U2 - 10.1016/j.injury.2011.06.003
DO - 10.1016/j.injury.2011.06.003
M3 - Article
SN - 0020-1383
VL - 42
SP - 985
EP - 991
JO - Injury
JF - Injury
IS - 10
ER -