Pelvic fractures in blunt trauma patients:A comparative study

作     者：Alexander A Fokin Joanna Wycech Knight Madison E Tharp Kyler C Brinton Phoebe K Gallagher Justin Fengyuan Xie Russell D Weisz Ivan Puente 

作者机构：Trauma and Critical Care ServicesDelray Medical CenterDelray BeachFL 33484United States Charles E Schmidt College of MedicineDepartment of SurgeryFlorida Atlantic UniversityBoca RatonFL 33431United States Trauma and Critical Care ServicesBroward Health Medical CenterFort LauderdaleFL 33316United States Charles E Schmidt College of MedicineFlorida Atlantic UniversityBoca RatonFL 33431United States Herbert Wertheim College of MedicineDepartment of SurgeryFlorida International UniversityMiamiFL 33199United States 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2024年第15卷第5期

页      面：418-434页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Pelvic fractures Geriatric trauma patients Abdominal co-injuries Contrast blush Contrast extravasation Angioembolization Polytrauma patients Surgical interventions Blunt trauma External and internal fixation for pelvic stabilization 

摘      要：BACKGROUND Pelvic fractures(PF)with concomitant injuries are on the rise due to an increase of high-energy *** of the elderly population with age related comorbidities further complicates the *** organ injuries are kindred with PF due to the proximity to pelvic *** of contrast blush(CB)on computed tomography in patients with PF is considered a sign of active bleeding,however,its clinical significance and association with outcomes is *** To analyze polytrauma patients with PF with a focus on the geriatric population,co-injuries and the value of contrast *** This retrospective cohort study included 558 patients with PF admitted to level 1 trauma center(01/2017-01/2023).Analyzed variables included:Age,sex,mechanism of injury(MOI),injury severity score(ISS),Glasgow coma scale(GCS),abbreviated injury scale(AIS),co-injuries,transfusion requirements,pelvic angiography,embolization,laparotomy,orthopedic pelvic surgery,intensive care unit and hospital lengths of stay,discharge disposition and *** study compared geriatric and non-geriatric patients,patients with and without CB and abdominal *** score matching was implemented in comparison *** PF comprised 4%of all trauma admissions.89 patients had CB.286(52%)patients had concomitant injuries including 93(17%)patients with abdominal *** patients compared to non-geriatric had more falls as MOI,lower ISS and AIS pelvis,higher GCS,less abdominal co-injuries,similar CB and angio-embolization rates,less orthopedic pelvic surgeries,shorter lengths of stay and higher *** propensity matching,orthopedic pelvic surgery rates remained lower(8%vs 19%,P0.001),hospital length of stay shorter,and mortality higher(13%vs 4%,P0.001)in geriatric *** of 89 patients with CB,45(51%)were *** propensity matching,patients with CB compared to without CB had more pelvic angiography(71%vs 12%,P0.001),hi