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. 2022 Aug 15;22(1):669.
doi: 10.1186/s12877-022-03223-z.

The impact of specific fracture characteristics of low-energy fractures of the pelvis on mortality

Michaela Ramser  1 , Werner Vach  2   3 , Nathalie Strub  2 , Dieter Cadosch  4 , Franziska Saxer #  2   5 , Henrik Eckardt #  4
Affiliations

The impact of specific fracture characteristics of low-energy fractures of the pelvis on mortality

Michaela Ramser et al. BMC Geriatr. .

Abstract

Background: Pelvic fractures in older patients are associated with relevant morbidity and mortality. Both might be determined by fracture morphology and/or patient characteristics. The aim of this project is to investigate the prognostic value of specific fracture characteristics with respect to overall survival and to compare it with an established classification system.

Methods: Retrospective analysis of patients ≥ 60 years, treated conservatively for a CT-scan verified, low-energy pelvic ring fracture between August 2006 and December 2018. Survival data was available from patients' charts and cantonal or national registries. The prognostic value of fracture characteristic describing the anterior and posterior involvement of the pelvic ring was investigated. This analysis was repeated after patients were stratified into a high-risk vs a low-risk group according to patient characteristic (age, gender, comorbidities, mobility, living situation). This allowed to assess the impact of the different fracture morphologies on mortality in fit vs. frail senior patients separately.

Results: Overall, 428 patients (83.4% female) with a mean age of 83.7 years were included. Two thirds of patients were still living in their home and mobile without walking aid at baseline. In-hospital mortality was 0.7%, overall, one-year mortality 16.9%. An independent and significant association of age, gender and comorbidities to overall survival was found. Further, the occurrence of a horizontal sacral fracture as well as a ventral comminution or dislocation was associated with an increased mortality. The effect of a horizontal sacral fracture was more accentuated in low-risk patients while the ventral fracture components showed a larger effect on survival in high-risk patients.

Conclusion: Specific fracture characteristics may indicate a higher risk of mortality in conservatively treated patients with a low-energy pelvic ring fracture. Hence, they should be taken into account in future treatment algorithms and decisions on patient management.

Keywords: FFP; Fracture characteristics; Fragility fractures of the pelvis; Frailty; Mortality; Older patients; Pelvic fracture.

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Conflict of interest statement

No competing interests.

Figures

Fig. 1
Fig. 1
Variables of the risk score
Fig. 2
Fig. 2
Relation of patient characteristics to mortality
Fig. 3
Fig. 3
Relation of the individual fracture characteristics to survival
Fig. 4
Fig. 4
Survival according to stratified patients risk. The patients were grouped into six classes of equal size (see also Fig. 1)
Fig. 5
Fig. 5
Relation of the individual fracture characteristics to survival within high- and low-risk patients
Fig. 6
Fig. 6
Correlation of the FFP classification to survival
See this image and copyright information in PMC

References

    1. Clement ND, Court-Brown CM. Elderly pelvic fractures: the incidence is increasing and patient demographics can be used to predict the outcome. Eur J Orthop Surg Traumatol. 2014;24(8):1431–1437. doi: 10.1007/s00590-014-1439-7. - DOI - PubMed
    1. Oberkircher L, et al. Osteoporotic Pelvic Fractures Dtsch Arztebl Int. 2018;115:70–80. doi: 10.3238/arztebl.2018.0070. - DOI - PMC - PubMed
    1. Krappinger D, et al. Fractures of the pubic rami: a retrospective review of 534 cases. Arch Orthop Trauma Surg. 2009;129(12):1685–1690. doi: 10.1007/s00402-009-0942-5. - DOI - PubMed
    1. Morris RO, et al. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards. Postgrad Med J. 2000;76(900):646–650. doi: 10.1136/pmj.76.900.646. - DOI - PMC - PubMed
    1. Hill, R.M., C.M. Robinson, and J.F. Keating, Fractures of the pubic rami. Epidemiology and five-year survival. J Bone Joint Surg Br. 2001;83(8):1141–4. - PubMed

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