Prevalence of Pelvic Fractures, Associated Injuries, and Mortality: The United Kingdom Perspective
BACKGROUND:We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facil...
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| Veröffentlicht in: | The Journal of trauma, injury, infection, and critical care injury, infection, and critical care, 2007-10, Vol.63 (4), p.875-883 |
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| container_title | The Journal of trauma, injury, infection, and critical care |
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| creator | Giannoudis, Peter V. Grotz, Martin R. W. Tzioupis, Christopher Dinopoulos, Haralambos Wells, Gareth E. Bouamra, Otmar Lecky, Fiona |
| description | BACKGROUND:We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facilities in the receiving hospitals on outcome.
METHODS:Prospective data from 106 trauma receiving hospitals forming the Trauma Audit and Research Network were studied. Between January 1989 and December 2001 data of 159,746 trauma patients were collected in the Trauma Audit and Research Network database. Because of incomplete data, 1,610 pelvic fracture patients and 13,499 patients without pelvic fracture were excluded from detailed analysis. In total, 11,149 patients in the PG and the remaining 133,486 patients in the NPG (control) group were included in the final analysis.
RESULTS:There were statistically significantly more patients with an Injury Severity Score >15 in the PG group (n = 3,576; 32.1%) than in NPG group (n = 19,238; 14.4%) (p < 0.001), indicating that pelvic injuries were more often associated with other injuries. The majority of patients sustained Abbreviated Injury Score (AIS) 2 pelvic injuries (65.0%), whereas AIS 4 and 5 injuries were found in less than 10% of patients. Pelvic ring injuries were most commonly associated with chest trauma with >AIS 2 severity in 21.2% of the patients, head injuries (>AIS 2) in 16.9%, liver or spleen injuries in 8.0%, and two or more long bone fractures in 7.8%. The 3-month cumulative mortality rate of the patients with pelvic injuries was 14.2% (1,586 patients) versus 5.6% (7,465 patients) of the NPG group.
CONCLUSION:Age, early physiologic derangement, and presence of other injuries (head or trunk) were associated with reduced survival rates. When the expertise to deal with such a group of patients is not available, early transfer under safe conditions should be considered to improve survival rates. |
| doi_str_mv | 10.1097/01.ta.0000242259.67486.15 |
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METHODS:Prospective data from 106 trauma receiving hospitals forming the Trauma Audit and Research Network were studied. Between January 1989 and December 2001 data of 159,746 trauma patients were collected in the Trauma Audit and Research Network database. Because of incomplete data, 1,610 pelvic fracture patients and 13,499 patients without pelvic fracture were excluded from detailed analysis. In total, 11,149 patients in the PG and the remaining 133,486 patients in the NPG (control) group were included in the final analysis.
RESULTS:There were statistically significantly more patients with an Injury Severity Score >15 in the PG group (n = 3,576; 32.1%) than in NPG group (n = 19,238; 14.4%) (p < 0.001), indicating that pelvic injuries were more often associated with other injuries. The majority of patients sustained Abbreviated Injury Score (AIS) 2 pelvic injuries (65.0%), whereas AIS 4 and 5 injuries were found in less than 10% of patients. Pelvic ring injuries were most commonly associated with chest trauma with >AIS 2 severity in 21.2% of the patients, head injuries (>AIS 2) in 16.9%, liver or spleen injuries in 8.0%, and two or more long bone fractures in 7.8%. The 3-month cumulative mortality rate of the patients with pelvic injuries was 14.2% (1,586 patients) versus 5.6% (7,465 patients) of the NPG group.
CONCLUSION:Age, early physiologic derangement, and presence of other injuries (head or trunk) were associated with reduced survival rates. When the expertise to deal with such a group of patients is not available, early transfer under safe conditions should be considered to improve survival rates.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/01.ta.0000242259.67486.15</identifier><identifier>PMID: 18090020</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adult ; Age Distribution ; Biological and medical sciences ; Causality ; Comorbidity ; Diseases of the osteoarticular system ; Female ; Fractures, Bone - epidemiology ; Fractures, Bone - therapy ; Humans ; Incidence ; Injuries of the limb. Injuries of the spine ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Injury Severity Score ; Intensive Care Units - statistics & numerical data ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Multiple Trauma - epidemiology ; Orthopedics - statistics & numerical data ; Outcome and Process Assessment (Health Care) ; Pelvic Bones - injuries ; Prevalence ; Prospective Studies ; Regression Analysis ; Sex Distribution ; Survival Analysis ; Traumas. Diseases due to physical agents ; United Kingdom - epidemiology</subject><ispartof>The Journal of trauma, injury, infection, and critical care, 2007-10, Vol.63 (4), p.875-883</ispartof><rights>2007 Lippincott Williams & Wilkins, Inc.</rights><rights>2007 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4564-c0dbb26b9d7a42abc68ab07613bf0f886a814b5b3245e3a0a077ae54e7338f663</citedby><cites>FETCH-LOGICAL-c4564-c0dbb26b9d7a42abc68ab07613bf0f886a814b5b3245e3a0a077ae54e7338f663</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=19174676$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18090020$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giannoudis, Peter V.</creatorcontrib><creatorcontrib>Grotz, Martin R. W.</creatorcontrib><creatorcontrib>Tzioupis, Christopher</creatorcontrib><creatorcontrib>Dinopoulos, Haralambos</creatorcontrib><creatorcontrib>Wells, Gareth E.</creatorcontrib><creatorcontrib>Bouamra, Otmar</creatorcontrib><creatorcontrib>Lecky, Fiona</creatorcontrib><title>Prevalence of Pelvic Fractures, Associated Injuries, and Mortality: The United Kingdom Perspective</title><title>The Journal of trauma, injury, infection, and critical care</title><addtitle>J Trauma</addtitle><description>BACKGROUND:We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facilities in the receiving hospitals on outcome.
METHODS:Prospective data from 106 trauma receiving hospitals forming the Trauma Audit and Research Network were studied. Between January 1989 and December 2001 data of 159,746 trauma patients were collected in the Trauma Audit and Research Network database. Because of incomplete data, 1,610 pelvic fracture patients and 13,499 patients without pelvic fracture were excluded from detailed analysis. In total, 11,149 patients in the PG and the remaining 133,486 patients in the NPG (control) group were included in the final analysis.
RESULTS:There were statistically significantly more patients with an Injury Severity Score >15 in the PG group (n = 3,576; 32.1%) than in NPG group (n = 19,238; 14.4%) (p < 0.001), indicating that pelvic injuries were more often associated with other injuries. The majority of patients sustained Abbreviated Injury Score (AIS) 2 pelvic injuries (65.0%), whereas AIS 4 and 5 injuries were found in less than 10% of patients. Pelvic ring injuries were most commonly associated with chest trauma with >AIS 2 severity in 21.2% of the patients, head injuries (>AIS 2) in 16.9%, liver or spleen injuries in 8.0%, and two or more long bone fractures in 7.8%. The 3-month cumulative mortality rate of the patients with pelvic injuries was 14.2% (1,586 patients) versus 5.6% (7,465 patients) of the NPG group.
CONCLUSION:Age, early physiologic derangement, and presence of other injuries (head or trunk) were associated with reduced survival rates. When the expertise to deal with such a group of patients is not available, early transfer under safe conditions should be considered to improve survival rates.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Biological and medical sciences</subject><subject>Causality</subject><subject>Comorbidity</subject><subject>Diseases of the osteoarticular system</subject><subject>Female</subject><subject>Fractures, Bone - epidemiology</subject><subject>Fractures, Bone - therapy</subject><subject>Humans</subject><subject>Incidence</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Injury Severity Score</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multiple Trauma - epidemiology</subject><subject>Orthopedics - statistics & numerical data</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Pelvic Bones - injuries</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><subject>Sex Distribution</subject><subject>Survival Analysis</subject><subject>Traumas. Diseases due to physical agents</subject><subject>United Kingdom - epidemiology</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE9v1DAQxS0EotvCV0DhACcS_N8Jt6qipaKIHtqzNXYc1sWbLLazVb89zu5KOxdr_H7zZvQQ-khwQ3CnvmLSZGhwKcopFV0jFW9lQ8QrtCKCdnXb4u41WhWd1oK29Aydp_RUeM5Z-xadkaIXEa-QuY9uB8GN1lXTUN27sPO2uo5g8xxd-lJdpjRZD9n11e34NEe_fMLYV7-mmCH4_PKteli76nH0C_PTj3_6aVOMYto6m_3OvUNvBgjJvT--F-jx-vvD1Y_67vfN7dXlXW25kLy2uDeGStP1CjgFY2ULBitJmBnw0LYSWsKNMIxy4RhgwEqBE9wpxtpBSnaBPh98t3H6N7uU9cYn60KA0U1z0rIrbgIvYHcAbZxSim7Q2-g3EF80wXoJWGOiM-hTwHofsCaizH44LpnNxvWnyWOiBfh0BCBZCEOE0fp04jqiuFTLEfzAPU8hl7D-hvnZRb12EPJ6v1owxWqKsSJLV--PYf8Bg8qTww</recordid><startdate>200710</startdate><enddate>200710</enddate><creator>Giannoudis, Peter V.</creator><creator>Grotz, Martin R. 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W. ; Tzioupis, Christopher ; Dinopoulos, Haralambos ; Wells, Gareth E. ; Bouamra, Otmar ; Lecky, Fiona</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4564-c0dbb26b9d7a42abc68ab07613bf0f886a814b5b3245e3a0a077ae54e7338f663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Biological and medical sciences</topic><topic>Causality</topic><topic>Comorbidity</topic><topic>Diseases of the osteoarticular system</topic><topic>Female</topic><topic>Fractures, Bone - epidemiology</topic><topic>Fractures, Bone - therapy</topic><topic>Humans</topic><topic>Incidence</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Injury Severity Score</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multiple Trauma - epidemiology</topic><topic>Orthopedics - statistics & numerical data</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Pelvic Bones - injuries</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Regression Analysis</topic><topic>Sex Distribution</topic><topic>Survival Analysis</topic><topic>Traumas. Diseases due to physical agents</topic><topic>United Kingdom - epidemiology</topic><toplevel>online_resources</toplevel><creatorcontrib>Giannoudis, Peter V.</creatorcontrib><creatorcontrib>Grotz, Martin R. W.</creatorcontrib><creatorcontrib>Tzioupis, Christopher</creatorcontrib><creatorcontrib>Dinopoulos, Haralambos</creatorcontrib><creatorcontrib>Wells, Gareth E.</creatorcontrib><creatorcontrib>Bouamra, Otmar</creatorcontrib><creatorcontrib>Lecky, Fiona</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 Journal of trauma, injury, infection, and critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giannoudis, Peter V.</au><au>Grotz, Martin R. W.</au><au>Tzioupis, Christopher</au><au>Dinopoulos, Haralambos</au><au>Wells, Gareth E.</au><au>Bouamra, Otmar</au><au>Lecky, Fiona</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of Pelvic Fractures, Associated Injuries, and Mortality: The United Kingdom Perspective</atitle><jtitle>The Journal of trauma, injury, infection, and critical care</jtitle><addtitle>J Trauma</addtitle><date>2007-10</date><risdate>2007</risdate><volume>63</volume><issue>4</issue><spage>875</spage><epage>883</epage><pages>875-883</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><abstract>BACKGROUND:We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facilities in the receiving hospitals on outcome.
METHODS:Prospective data from 106 trauma receiving hospitals forming the Trauma Audit and Research Network were studied. Between January 1989 and December 2001 data of 159,746 trauma patients were collected in the Trauma Audit and Research Network database. Because of incomplete data, 1,610 pelvic fracture patients and 13,499 patients without pelvic fracture were excluded from detailed analysis. In total, 11,149 patients in the PG and the remaining 133,486 patients in the NPG (control) group were included in the final analysis.
RESULTS:There were statistically significantly more patients with an Injury Severity Score >15 in the PG group (n = 3,576; 32.1%) than in NPG group (n = 19,238; 14.4%) (p < 0.001), indicating that pelvic injuries were more often associated with other injuries. The majority of patients sustained Abbreviated Injury Score (AIS) 2 pelvic injuries (65.0%), whereas AIS 4 and 5 injuries were found in less than 10% of patients. Pelvic ring injuries were most commonly associated with chest trauma with >AIS 2 severity in 21.2% of the patients, head injuries (>AIS 2) in 16.9%, liver or spleen injuries in 8.0%, and two or more long bone fractures in 7.8%. The 3-month cumulative mortality rate of the patients with pelvic injuries was 14.2% (1,586 patients) versus 5.6% (7,465 patients) of the NPG group.
CONCLUSION:Age, early physiologic derangement, and presence of other injuries (head or trunk) were associated with reduced survival rates. When the expertise to deal with such a group of patients is not available, early transfer under safe conditions should be considered to improve survival rates.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>18090020</pmid><doi>10.1097/01.ta.0000242259.67486.15</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Age Distribution Biological and medical sciences Causality Comorbidity Diseases of the osteoarticular system Female Fractures, Bone - epidemiology Fractures, Bone - therapy Humans Incidence Injuries of the limb. Injuries of the spine Injuries of the nervous system and the skull. Diseases due to physical agents Injury Severity Score Intensive Care Units - statistics & numerical data Length of Stay - statistics & numerical data Male Medical sciences Multiple Trauma - epidemiology Orthopedics - statistics & numerical data Outcome and Process Assessment (Health Care) Pelvic Bones - injuries Prevalence Prospective Studies Regression Analysis Sex Distribution Survival Analysis Traumas. Diseases due to physical agents United Kingdom - epidemiology |
| title | Prevalence of Pelvic Fractures, Associated Injuries, and Mortality: The United Kingdom Perspective |
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