Related Experiment Video
Updated: May 23, 2025
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Associated peritoneostomy and pelvic ring fractures: prognostic factors in mortality and morbidity
Uheyna Gancedo Ruzon1, Thayná Caroline Da Silva1, Christiano Saliba Uliana2
1Complexo Hospitalar do Trabalhador, Curitiba, PR, Brazil.
Insights
High-energy polytrauma with pelvic fractures and emergency peritoneostomy significantly increases mortality risk, especially for patients over 45. Lack of internal fixation is a key predictor of poor outcomes in these critical trauma cases.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Orthopedic Surgery
Background:
- High-energy polytrauma frequently involves abdominal injuries combined with pelvic ring fractures.
- The combination of pelvic ring fracture and emergency peritoneostomy at admission is associated with elevated morbidity and mortality rates.
Purpose of the Study:
- To identify prognostic factors influencing outcomes in polytrauma patients with pelvic ring fractures undergoing emergency peritoneostomy.
- To evaluate the functional outcomes of survivors in this patient cohort.
Main Methods:
- A retrospective, cross-sectional, observational study design was employed.
- Included were polytrauma patients with high-energy abdominal injury, pelvic ring fracture, and admission peritoneostomy.
- Data collected included demographics, prognostic factors for mortality and infection, and functional outcomes using the Majeed score.
Main Results:
- The study included 29 patients, with a high mortality rate of 58.6%.
- Mortality surged to 90% in patients older than 45 years.
- Positive correlations with death included age > 45 years (p < 0.017) and absence of internal fixation (p < 0.011).
- Internal fixation was associated with higher infection rates (60%) compared to non-internal fixation (11%) (p < 0.011).
- The average Majeed score for functional evaluation was 54.7.
Conclusions:
- Age over 45 years and the absence of internal fixation are significant predictors of increased mortality.
- The concurrent presence of pelvic ring fracture and emergency peritoneostomy at admission is linked to substantial mortality and morbidity.
Background:
High-energy polytrauma can be presented as an abdominal injury associated with a pelvic ring fracture. In the case of concomitant pelvic ring fracture peritoneostomy at admission, high morbidity and mortality rates could be expected.
Objectives:
The main objective of this study is to assess prognostic factors that could contribute to the outcome of polytrauma patients who presented with pelvic ring fractures and were submitted to a peritoneostomy at admission. As a secondary aim, the functional outcome of the survivors was evaluated.
Materials And Methods:
A retrospective, cross-sectional, observational study was conducted. Polytrauma patients who were submitted to a peritoneostomy at admission due to high-energy abdominal injury and presented with concomitant pelvic ring fracture were included. Demographics data and prognostic factors related to "death" and infection were assessed. We applied the Majeed score for functional evaluation.
Results:
A total of 29 patients were included in the study. The mortality rate was 58.6% (n = 17). Considering only patients older than 45 years, the death rate was 90%. The variables with positive correlation to death were: (1) age > 45 years (p < 0.017) and (2) the absence of internal fixation (p < 0.011). Patients undergoing internal fixation had more infection rates (60%) compared to noninternal fixation group (11%) (p < 0.011). The average Majeed score was 54.7 points.
Conclusion:
The predictive factors associated with increased mortality were age greater than 45 years and the absence of internal fixation. Concomitant pelvic ring fracture and peritoneostomy in admission implicate on high mortality and morbidity rates.
