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. 2017 Dec 27;2(1):e000136.
doi: 10.1136/tsaco-2017-000136. eCollection 2017.

Current outcomes of blunt open pelvic fractures: how modern advances in trauma care may decrease mortality

Sammy S Siada  1 , James W Davis  1 , Krista L Kaups  1 , Rachel C Dirks  1 , Kimberly A Grannis  1
Affiliations

Current outcomes of blunt open pelvic fractures: how modern advances in trauma care may decrease mortality

Sammy S Siada et al. Trauma Surg Acute Care Open. .

Abstract

Background: Open pelvic fracture, caused by a blunt mechanism, is an uncommon injury with a high mortality rate. In 2008, evidence-based algorithm for managing pelvic fractures in unstable patients was published by the Western Trauma Association (WTA). The use of massive transfusion protocols has become widespread as has the availability and use of pelvic angiography. The purpose of this study was to evaluate the outcome of open pelvic fractures in association with related advances in trauma care.

Methods: A retrospective review was performed, at an American College of Surgeon verified level I trauma center, of patients with blunt open pelvic fractures from January 2010 to April 2016. The WTA algorithm, including massive transfusion protocol, and pelvic angiography were uniformly used. Data collected included injury severity score, demographic data, transfusion requirements, use of pelvic angiography, length of stay, and disposition. Data were compared with a similar study from 2005.

Results: During the study period, 1505 patients with pelvic fractures were analyzed; 87 (6%) patients had open pelvic fractures. Of these, 25 were from blunt mechanisms and made up the study population. Patients in both studies had similar injury severity scores, ages, Glasgow Coma Scale, and gender distributions. Use of angiography was higher (44% vs. 16%; P=0.011) and mortality was lower (16% vs. 45%; P=0.014) than in the 2005 study.

Conclusions: Changes in trauma care for patients with open blunt pelvic fracture include the use of an evidence-based algorithm, massive transfusion protocols and increased use of angioembolization. Mortality for open pelvic fractures has decreased with these advances.

Level of evidence: Level IV.

Keywords: Massive Transfusion; angiography; mortality; pelvic fracture.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Richardson JD, Harty J, Amin M, Flint LM. Open pelvic fractures. J Trauma 1982;22:533–8. doi:10.1097/00005373-198207000-00002 - DOI - PubMed
    1. Rothenberger D, Velasco R, Strate R, Fischer RP, Perry JF. Open pelvic fracture: a lethal injury. J Trauma 1978;18:184–7. - PubMed
    1. Jones AL, Powell JN, Kellam JF, McCormack RG, Dust W, Wimmer P. Open pelvic fractures. A multicenter retrospective analysis. Orthop Clin North Am 1997;28:345–50. - PubMed
    1. Hanson PB, Milne JC, Chapman MW. Open pelvis fractures. Review of 43 cases. J Bone Joint Surg Br 1991;73:325–9. - PubMed
    1. Dente CJ, Feliciano DV, Rozycki GS, Wyrzykowski AD, Nicholas JM, Salomone JP, Ingram WL. The outcome of open pelvic fractures in the modern era. Am J Surg 2005;190:831–7. doi:10.1016/j.amjsurg.2005.05.050 - DOI - PubMed