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Decrease in adjusted pelvic fracture mortality rates found after multidisciplinary protocol
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Results of this retrospective database analysis showed a significant decrease in adjusted pelvic fracture mortality rates in healthy patients with unstable pelvic fractures at a single trauma center after implementation of multidisciplinary pelvic fracture protocol.
Researchers compared the results of 1,682 patients with pelvic fractures to a control group of 42,629 patients without pelvic fractures who were treated before and after initiation of a multidisciplinary institutional protocol to guide the initial management of trauma patients with pelvic fractures. Researchers grouped patients into one of the following periods based on their year of treatment: 2000 to 2003; 2004 to 2007; and 2008 to 2013. The multidisciplinary protocol was instituted in 2003.
Sheena R. Black
Results showed the pelvic fracture group had a significant association between mortality and age, shock, severe head injury, increasing Injury Severity Score and earlier study period. However, mortality after pelvic fracture decreased during the study period after investigators adjusted their findings for patient age, Glasgow Coma Scale score, systolic blood pressure and Injury Severity Score. Although examination of mortality in specific subsets of patients with pelvic fractures did not show a statistically significant change with time, researchers found the subset of patients who were not in shock, did not have a severe head injury, were not elderly and had an unstable fracture pattern experienced decreased mortality rates after initiation of the protocol.
According to results from a univariate statistical analysis, the healthiest patients with unstable fracture patterns experienced increased mortality from 2000 to 2003 vs. the healthiest patients with stable fracture patterns (8.6% vs. 0%). From 2008 to 2013, the healthiest patients with an unstable fracture pattern had a mortality rate of 2.8% vs. 0.6% in the healthiest patients with stable fracture patterns. – by Casey Tingle
Disclosures: Black reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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