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Updated: Jun 16, 2025

Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Don't ignore the patient with a "fragility fracture"! Risk factors for bleeding from stable pelvic fractures
Walter L Biffl1, Ali Sepahdari2, Matthew Castelo2
1Scripps Clinic/Scripps Clinic Medical Group, Division of Trauma/Acute Care Surgery, 9898 Genesee Ave, AMP 130, La Jolla, CA, 92037, USA; Scripps Memorial Hospital La Jolla, 9888 Genesee Ave., LJ601, La Jolla, CA, 92037, USA.
Background:
Stable pelvic fractures are common in elderly patients. Significant bleeding (SigBleed)- requiring transfusion or angioembolization- is reported in 9-15 %. Bleeding risk factors are poorly defined. We hypothesized that SigBleed is related to antithrombotic therapy and sarcopenia.
Methods:
Level I trauma center retrospective review (2015-2021). Primary outcome was SigBleed. Sarcopenia measured by psoas:lumbar vertebral body index (PLVI).
Results:
141 patients (70% female; mean age 80; 52% on antithrombotics) had mean Injury Severity Score (ISS) 8.8, mean PLVI 0.50. 24% had adverse hematoma characteristics. 22% had SigBleed: 28 (20%) received transfusion and 15 (11%) angioembolization. Adverse hematoma characteristics and ISS were independent predictors of SigBleed; PLVI (OR 0.01 [0.00002, 0.88], p = 0.065) and antithrombotics were not significant.
Conclusions:
Older patients with stable pelvic fractures have a relatively high rate of clinically-important bleeding. Awareness of the issue and identification of risk factors is important. The relationship between sarcopenia and bleeding requires further study.
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