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Mortality in multiple trauma patients with fractures
L B Bone1, K McNamara, B Shine
1State University of New York at Buffalo.
The Journal of Trauma
|August 1, 1994
Summary
Early total care, including fracture stabilization, significantly reduces mortality in patients with multiple injuries and major fractures. This approach benefits both younger and older patients, especially those with severe injury scores.
Area of Science:
- Trauma Surgery
- Orthopedic Surgery
- Critical Care Medicine
Background:
- Multiple injuries with major fractures present a high mortality risk.
- Optimal management strategies for these complex trauma patients are crucial.
Purpose of the Study:
- To determine the impact of early total care on mortality rates in patients with multiple injuries and major pelvic/long bone fractures.
- To compare outcomes between early total care and other management approaches.
Main Methods:
- A multicentered study reviewed 676 patients with Injury Severity Scores (ISS) > or = 18 and major fractures.
- Data was compared to a control group of 906 patients from the American College of Surgeons' Multiple Trauma Outcome Study.
- Analysis focused on mortality reduction with early total care, including acute fracture stabilization.
Main Results:
- Early total care significantly reduced mortality across all age groups and ISS categories.
- In patients <50 years with ISS 18-45, mortality decreased from 11.8%-25.8% to 5.1%-11.5%.
- In patients >=50 years with ISS 18-45, mortality decreased from 26.4%-42.3% to 8%-18.4%.
Conclusions:
- Early total care, encompassing acute fracture stabilization, is associated with significantly lower mortality rates in polytrauma patients.
- This management strategy offers substantial survival benefits for both younger and older patients with severe injuries.