Bleeding Risk Associated With Hemodynamically Stable Low-Energy Pelvic Fracture

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Trauma Surgery

Background:

• Low-energy pelvic fractures in the elderly can lead to significant bleeding.
• Limited data exists on bleeding risk in hemodynamically stable osteoporotic pelvic fractures.
• This study investigates bleeding risk in this specific patient population.

Purpose of the Study:

• To estimate the bleeding risk associated with low-energy osteoporotic pelvic fractures in elderly patients.
• To analyze hemoglobin (Hb) level changes in this demographic.
• To assess the impact of anticoagulation on bleeding risk.

Main Methods:

• Retrospective review of patients aged over 65 with pelvic fractures (2015-2018).
• Analysis of 82 patients (median age 86), including fracture types and comorbidity index.
• Evaluation of Hb levels, blood transfusion requirements, and effect of anticoagulation.

Main Results:

• Significant Hb drops observed on day 1 (11.22 g/dL) and day 4 (10.97 g/dL).
• Nine percent of patients required blood transfusion, with a mean pre-transfusion Hb of 8.33 g/dL.
• Anticoagulation did not correlate with increased Hb decrease on day 1 or day 4.

Conclusions:

• Hemodynamically stable elderly patients with osteoporotic pelvic fractures can experience a mean Hb decrease of up to 1.4 g/dL.
• This Hb decrease is clinically significant for geriatric patients with anemia or cardiovascular disease.
• Osteoporotic pelvic fractures represent a notable bleeding risk in the elderly.