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Published on: November 8, 2024
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Pelvic fractures in blunt trauma patients: A comparative study
Alexander A Fokin1,2, Joanna Wycech Knight1,3, Madison E Tharp1,4
1Trauma and Critical Care Services, Delray Medical Center, Delray Beach, FL 33484, United States.
World Journal of Orthopedics
|June 5, 2024
Summary
Pelvic fractures (PF) with concomitant injuries impact trauma patients, especially the elderly, who face higher mortality. Contrast blush (CB) on CT scans in PF patients often necessitates embolization, though mortality remains comparable.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Radiology
Background:
- High-energy trauma leads to an increase in pelvic fractures (PF) with associated injuries.
- Managing PF in the elderly is complicated by comorbidities.
- Contrast blush (CB) on CT scans for PF is a marker of active bleeding, but its clinical significance is debated.
Purpose of the Study:
- To analyze polytrauma patients with PF, focusing on geriatric patients, co-injuries, and the clinical value of contrast blush (CB).
Main Methods:
- Retrospective cohort study of 558 PF patients (2017-2023) at a Level 1 trauma center.
- Analysis included demographics, injury characteristics, co-injuries, and treatment outcomes.
- Propensity score matching was used to compare geriatric vs. non-geriatric patients and patients with/without CB.
Main Results:
- PF constituted 4% of trauma admissions; 52% had co-injuries (17% abdominal).
- Geriatric patients had higher mortality (13% vs. 4%) and fewer orthopedic surgeries despite similar CB rates.
- Patients with CB underwent more pelvic angiography (71% vs. 12%) and embolization (64% vs. 22%), with comparable mortality.
Conclusions:
- Pelvic fractures frequently present with co-injuries, including abdominal trauma.
- Geriatric patients with similar injuries exhibit higher mortality rates.
- Approximately half of patients with contrast blush on CT scans require embolization.
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