Auditing 655 fatalities with pelvic fractures by autopsy as a basis to evaluate trauma care
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Iordanis N Papadopoulos1, Nikolaos Kanakaris, Stefanos Bonovas
1National University of Athens, Attikon University General Hospital, Athens, Greece. ipapado@med.uoa.gr
Background:
To determine the role of pelvic fractures in auditing mortality resulting from trauma.
Study Design:
This retrospective case-control study based on autopsy-evaluated circumstances of the deaths of patients with pelvic fractures.
Results:
Of 2,583 patients injured in motor-vehicle collisions, 655 (25.4%) constituted the pelvic fracture (PFx) group, and 1,928 (74.6%) constituted the control group. One-third of the PFx group's fatalities had an Injury Severity Score (ISS) of 75 and were not preventable. The PFx group had a substantially higher median ISS than the control group (50 versus 34; p < 0.0001). Four hundred fifty-four patients (69.3%) in the PFx group with ISS 16 to 74 had substantially higher rates of associated injuries. Nearly half of the PFx group patients with ISS
Conclusions:
Pelvic fracture is an indicator of severe multiple trauma, but a small proportion of deaths are directly attributable to pelvic fracture. A method based on autopsy audited patients with pelvic fractures as a paradigm of injury revealed that pelvic fracture is an important injury to consider in auditing trauma care and indicated several issues that should be considered to reduce mortality.
