Mariscal G, Dway A, Barrios C. Hidden dangers of pelvic fracture: A meta-analysis on urinary tract injury incidence and risk factors. World J Orthop 2025; 16(2): 102483 [DOI: 10.5312/wjo.v16.i2.102483]
Corresponding Author of This Article
Ali Dway, Faculty of Medicine, Al-Andalus University for Medical Sciences, AL Thawra Street, Tartus 000, Syria. dwayali10@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Feb 18, 2025; 16(2): 102483 Published online Feb 18, 2025. doi: 10.5312/wjo.v16.i2.102483
Hidden dangers of pelvic fracture: A meta-analysis on urinary tract injury incidence and risk factors
Gonzalo Mariscal, Ali Dway, Carlos Barrios
Gonzalo Mariscal, Carlos Barrios, Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia 46700, Spain
Ali Dway, Faculty of Medicine, Al-Andalus University for Medical Sciences, Tartus 000, Syria
Author contributions: Mariscal G, Dway A and Barrios C designed the research study; Mariscal G, Dway A and Barrios C performed the research; Mariscal G analyzed the data; Mariscal G and Dway A wrote the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali Dway, Faculty of Medicine, Al-Andalus University for Medical Sciences, AL Thawra Street, Tartus 000, Syria. dwayali10@gmail.com
Received: October 21, 2024 Revised: December 17, 2024 Accepted: January 14, 2025 Published online: February 18, 2025 Processing time: 116 Days and 5.8 Hours
Abstract
BACKGROUND
Pelvic fractures are often associated with significant morbidity, including injuries to the urinary tract. Understanding the incidence and risk factors for urinary tract injury in these patients is crucial for prompt diagnosis and management. This meta-analysis aims to synthesize existing evidence to determine the overall incidence and identify specific risk factors associated with urinary tract injuries in patients with pelvic fractures.
AIM
To determine the incidence and risk factors for urinary tract injuries in patients with pelvic fractures.
METHODS
A systematic search of PubMed, EMBASE, Scopus, and the Cochrane Library was conducted without date restrictions. Studies examining the incidence and risk factors of urinary tract injuries in patients with pelvic fractures were included. Data extracted included demographics, injury mechanism, pelvic fracture type, urinary tract injury incidence, mortality, and discharge disposition. Review Manager 5.4 was used for data analysis.
RESULTS
Ten studies comprising 22700 patients were included. The pooled incidence of urinary tract injury associated with pelvic fracture was 6.88% (95%CI: 6.20%-7.55%). Vehicle, motorcycle, and pedestrian accidents were identified as risk factors for urinary tract injury, with relative risks (RR) of 1.08 (95%CI: 1.06-1.11), 1.89 (95%CI: 1.78-2.00), and 1.53 (95%CI: 1.20-1.95), respectively. Pubic fracture and pelvic ring disruption were significantly associated with urinary tract injury [odds ratio (OR) 1.94, 95%CI: 1.09-3.44 and OR 5.53, 95%CI: 4.67-6.54, respectively)]. Patients without urinary tract injury were more likely to be discharged home (RR 0.79, 95%CI: 0.67-0.92). Mortality was higher in patients with urinary tract injury (OR 1.92, 95%CI: 1.77-2.09).
CONCLUSION
Urinary tract injury occurs in nearly 7% of patients with pelvic fractures. Motorcycle accidents, pubic fractures, and pelvic ring disruptions are significant risk factors. Urinary tract injury following pelvic fracture is associated with increased mortality.
Core Tip: This meta-analysis investigates the incidence of urinary tract injuries associated with pelvic fractures, revealing a prevalence of 6.88%. It identifies key risk factors, including vehicle and motorcycle accidents, and highlights the significant associations between specific fracture types, such as pubic fractures and pelvic ring disruptions, and urinary injuries. The findings underscore the importance of early detection and intervention to reduce morbidity and mortality in affected patients.
