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Risk Factors, Clinical Outcomes, and Medical Costs of Pelvic Infection After Open Pelvic Fractures: A 7-Year

Donghwan Choi1, Jungsub So1, Won Tae Cho1

  • 1Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea.

Healthcare (Basel, Switzerland)
|May 27, 2026
PubMed

Insights

Open pelvic fractures (OPFs) can lead to pelvic infections (PIs). Age and anorectal injury are key risk factors for PIs, which significantly increase healthcare costs and treatment complexity.

Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Infectious Diseases

Background:

  • Open pelvic fractures (OPFs) present a high risk of pelvic infections (PIs) and sepsis, contrasting with the hemorrhagic shock typically seen in unstable pelvic fractures.
  • Understanding the clinical outcomes and risk factors for PIs in OPF patients is crucial for improving patient management and prognosis.

Purpose of the Study:

  • To investigate the incidence and independent risk factors associated with pelvic infections (PIs) in patients with open pelvic fractures (OPFs).
  • To analyze the clinical outcomes, including hospital length of stay, medical costs, and number of surgeries, in OPF patients who develop PIs compared to those who do not.

Main Methods:

  • Retrospective review of 44 patients with OPFs treated between March 2016 and February 2023.
  • Logistic regression analysis was employed to identify factors independently associated with the development of PIs.

Main Results:

  • Twenty-two of 44 OPF patients developed PIs.
  • Independent risk factors for PIs included older age (OR 1.082), higher serum lactate levels (OR 1.319), Gustilo-Anderson grade III injury (OR 7.467), and presence of anorectal injury (OR 36.468).
  • Patients with PIs experienced significantly longer hospital stays (84.0 vs 30.5 days), higher medical costs (USD 95,812 vs 33,224), and more surgeries (13.0 vs 4.5) compared to those without PIs.

Conclusions:

  • Age and anorectal injury are significant risk factors for developing pelvic infections in open pelvic fracture patients.
  • Serum lactate levels and Gustilo-Anderson grade III injuries showed potential associations with PIs, warranting further investigation.
  • Pelvic infections in OPF patients are associated with substantially increased healthcare utilization and costs, emphasizing the need for effective early management strategies.

Keywords:
medical costopen pelvic fracturespelvic infectionpelvic sepsissoft tissue infection

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