Pelvic Fracture May Increase Trauma Patients' Risk of Death
But it is only one variable among many, and some are more strongly associated with mortality
23 dec 2009-- In trauma patients, pelvic fracture is significantly associated with death, but its effect should be considered in relation to other variables, according to a study in the Dec. 1 issue of the Journal of Bone & Joint Surgery.
Ashoke K. Sathy, M.D., of the University of Texas Southwestern Medical Center in Dallas, and colleagues performed a regression analysis on 63,033 patients to compare mortality associated with pelvic fracture with other variables such as age, shock, head injury, abdominal or chest injury, and extremity injury. They also conducted a second analysis to see whether the impact of a pelvic fracture on mortality varied when combined with other known risk factors for mortality.
The researchers found that pelvic fracture was significantly associated with mortality, with an odds ratio (approximately 2) similar to that of an abdominal injury. However, they found that the odds ratio for mortality was slower for pelvic fracture than for other variables such as hemodynamic shock, severe head injury, and an age of 60 years or above.
"Presumably, for patients with severe head injury and shock, the mortality risk is so high that the pelvic fracture adds little to the overall risk," the authors conclude. "This does not mean pelvic fractures can be ignored in such patients. However, in our opinion, it seems advisable to exclude patients with severe head injury and shock from analyses of the effectiveness of treatment strategies that seek to lessen mortality after pelvic fracture, since it appears that pelvic fracture has little impact on the risk of death for such patients."