J Acute Care Surg.  2018 Apr;8(1):19-24. 10.17479/jacs.2018.8.1.19.

Risk Factors Associated with Mortality of Patients with Pelvic Fractures and Hemodynamic Instability in a Korean Trauma Center

• Kim MH
• Shim H
• Bae KS
• Ryu H
• Jang JY

• KMID: 2434951
• DOI: http://doi.org/10.17479/jacs.2018.8.1.19

Abstract

PURPOSE
The aim of this study is to evaluate treatment outcomes and mortality risks associated with hemodynamic instability caused by severe pelvic fracture in a regional trauma center.
METHODS
The medical charts of 44 patients with hemodynamic instability due to pelvic fractures who were admitted to a regional trauma center from January 2014 to May 2017 were analyzed retrospectively.
RESULTS
The mean age was 61.8 years, and the mean injury severity score was 39.1. Twenty-six patients (59.1%) were transferred from other hospitals, and the median time from injury to emergency room arrival was 115.5 minutes. Preperitoneal pelvic packing, pelvic angiography, and external pelvic fixation were performed in 38 patients (86.4%) for hemostasis. The mortality rate was 52.3%, and 15 patients (34.1%) died from hemorrhage. Logistic regression analysis showed that initial low systolic blood pressure and packed red blood cell (PRBC) requirement were independent risk factors associated with mortality. PRBC requirement for four hours and application of emergent hemostatic procedures were independent factors associated with hemorrhage-induced mortality.
CONCLUSION
Emergency procedures for hemostasis should be performed immediately for patients with hemodynamic instability due to pelvic fracture, and they should be transferred to a regional trauma center as soon as possible.

Keyword

Pelvis; Mortality; Risk factors; Shock; Trauma centers

MeSH Terms

Angiography
Blood Pressure
Emergencies
Emergency Service, Hospital
Erythrocytes
Hemodynamics*
Hemorrhage
Hemostasis
Humans
Injury Severity Score
Logistic Models
Mortality*
Pelvis
Retrospective Studies
Risk Factors*
Shock
Trauma Centers*