Type C pelvic ring fractures linked with highest mortality rate among pelvic fractures
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Compared with patients with isolated acetabular fractures, patients with pelvic ring fractures – specifically type C pelvic ring fractures – have higher mortality rates, according to published results.
Hoe Jeong Chung, MD, and colleagues analyzed 302 patients with pelvic bone fractures who received treatment at a level-1 trauma center between March 1, 2015, and Feb. 28, 2017. According to the study, patients were classified by anatomic type of fracture: pelvic ring injury (n = 195), acetabular fracture (n = 75) or combined fracture (n = 32). The researchers performed t test analysis of survival and death, as well as multivariate regression to analyze mortality factors.
Of the patients with pelvic ring injuries, 22.6% died; of the patients with combined fractures, 18.8% died; and of the patients with isolated acetabular fractures, 1.3% died. Researchers also noted that the mortality rate in patients with type A pelvic ring injuries was 8.2% and was 68.2% in patients with type C pelvic ring injuries – a “statistically significant” difference.
After multivariate regression, Chung and colleagues found age, combined injuries, high injury severity score and low initial systolic blood pressure were also risk factors for mortality in patients with pelvic fractures.
“Accurately identifying the anatomic type of pelvic bone fracture is critical because fracture type is related to pelvic stability after injury and ultimately the prognosis of the patient,” the researchers wrote in the study. “In cases of severe trauma where the pelvic bone fracture is combined with multiple organ injuries, prioritizing which injury to treat first is essential.”
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