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©The Author(s) 2024.
World J Orthop. May 18, 2024; 15(5): 418-434
Published online May 18, 2024. doi: 10.5312/wjo.v15.i5.418
Published online May 18, 2024. doi: 10.5312/wjo.v15.i5.418
Table 1 General characteristics of patients with pelvic fractures, n (%)
| Variable | Patients with pelvic fractures (n = 558) |
| Age, mean (SD) | 62.0 (22.6) |
| Geriatric | 291 (52.2) |
| Sex (Female/Male) | 284 (50.9) / 274 (49.1) |
| Comorbidities | 423 (75.8) |
| Anticoagulation | 152 (27.2) |
| Mechanism of injury | - |
| Fall | 204 (36.6) |
| Motor vehicle (Pedestrian/Bicycle/Motorcycle) | 344 (61.6) |
| Other (Assault, Crush) | 10 (1.8) |
| Glasgow coma scale, mean (SD) | 13.7 (3.3) |
| Injury severity score, mean (SD) | 15.7 (10.7) |
| AIS pelvis | - |
| 2 | 386 (69.2) |
| 3 | 62 (11.1) |
| 4 | 84 (15.1) |
| 5 | 26 (4.7) |
| Any blood transfusion | 220 (39.6) |
| Presence of co-injuries | 286 (51.3) |
| Co-Injury types | - |
| Head | 126 (22.6) |
| Spine | 81 (14.5) |
| Thoracic | 111 (19.9) |
| Abdominal | 93 (16.7) |
| CT with contrast | 448 (80.3) |
| Contrast blush | 89 (19.9) |
| Pelvic angiogram | 102 (18.3) |
| Pelvic embolization | 61 (59.8) |
| Pelvic orthopedic surgery | 74 (13.3) |
| Time: Admission to pelvic surgery, mean h | 75.0 |
| Exploratory laparotomy | 64 (11.5) |
| ICU admission | 321 (57.5) |
| ICU length of stay, mean days (SD) | 7.7 (9.3) |
| Hospital length of stay, mean days (SD) | 10.9 (17.5) |
| Do not resuscitate order | 77 (13.8) |
| Mortality | 40 (7.2) |
| Hospital discharge disposition | - |
| Expired in hospital | 14 (2.5) |
| Hospice | 26 (4.7) |
| Long term care hospital | 26 (4.7) |
| Skilled nursing facility | 126 (22.6) |
| Rehabilitation facility | 192 (34.4) |
| Home | 174 (31.2) |
Table 2 Comparison of non-geriatric and geriatric patients with pelvic fractures, n (%)
| Variable | Non-Geriatric (n = 267) | Geriatric (n = 291) | P values |
| Age, mean | 41.9 | 80.5 | < 0.001a |
| Sex (Female/Male) | 109 (40.8) / 158 (59.2) | 175 (60.1) / 116 (39.9) | < 0.001a |
| Comorbidities | 145 (54.3) | 278 (95.5) | < 0.001a |
| Anticoagulation | 14 (5.2) | 138 (47.4) | < 0.001a |
| Mechanism of injury | - | - | < 0.001a |
| Fall | 48 (18.0) | 156 (53.6) | - |
| Motor vehicle | 211 (79.0) | 133 (45.7) | - |
| Other | 8 (3.0) | 2 (0.7) | - |
| Glasgow coma scale, mean | 12.9 | 14.3 | < 0.001a |
| Injury severity score, mean | 17.5 | 14.0 | < 0.001a |
| AIS pelvis | - | - | 0.01a |
| 2 | 170 (63.7) | 216 (74.2) | - |
| 3 | 39 (14.6) | 23 (7.9) | - |
| 4 | 41 (15.4) | 43 (14.8) | - |
| 5 | 17 (6.4) | 9 (3.1) | - |
| Any blood transfusion | 108 (40.4) | 113 (38.8) | 0.3 |
| Co-injury types | - | - | - |
| Head | 66 (24.7) | 60 (20.6) | 0.2 |
| Spine | 37 (13.9) | 44 (15.1) | 0.7 |
| Thoracic | 51 (19.1) | 60 (20.6) | 0.7 |
| Abdominal | 58 (21.7) | 35 (12.0) | 0.002a |
| CT with contrast | 247 (92.5) | 201 (69.1) | < 0.001a |
| Contrast blush | 37 (15.0) | 36 (17.9) | 0.4 |
| Pelvic angiogram | 50 (18.7) | 52 (17.9) | 0.8 |
| Pelvic embolization | 30 (60.0) | 31 (59.6) | 0.9 |
| Pelvic orthopedic surgery | 58 (21.7) | 16 (5.5) | < 0.001a |
| Time: Admission to pelvic surgery, mean h | 66.2 | 106.8 | 0.1 |
| Exploratory laparotomy | 44 (16.5) | 20 (6.9) | < 0.001a |
| ICU Admission | 152 (56.9) | 169 (58.1) | 0.8 |
| ICU length of stay, mean days | 8.9 | 6.6 | 0.03a |
| Hospital length of stay, mean days | 14.5 | 7.7 | < 0.001a |
| Do not resuscitate order | 12 (4.5) | 65 (22.3) | < 0.001a |
| Mortality | 12 (4.5) | 28 (9.6) | 0.02a |
| Hospital discharge disposition | - | - | < 0.001a |
| Expired in hospital | 8 (3.0) | 6 (2.1) | - |
| Hospice | 4 (1.5) | 22 (7.6) | - |
| Long term care hospital | 13 (4.9) | 13 (4.5) | - |
| Skilled nursing facility | 18 (6.7) | 108 (37.1) | - |
| Rehabilitation facility | 91 (34.1) | 101 (34.7) | - |
| Home | 133 (49.8) | 41 (14.1) | - |
Table 3 Comparison of propensity score matched by abbreviated injury score of pelvis and mechanism of injury non-geriatric and geriatric patients with pelvic fractures, n (%)
| Variable | Non-geriatric (n = 183) | Geriatric (n = 183) | P value |
| Mechanism of injury | - | - | 0.8 |
| Fall | 48 (26.2) | 48 (26.2) | - |
| Motor vehicle | 134 (73.2) | 133 (72.7) | - |
| Other | 1 (0.5) | 2 (1.1) | - |
| AIS pelvis | - | - | 0.9 |
| 2 | 124 (67.8) | 127 (69.4) | - |
| 3 | 21 (11.5) | 17 (9.3) | - |
| 4 | 29 (15.8) | 30 (16.4) | - |
| 5 | 9 (4.9) | 9 (4.9) | - |
| Age, mean | 42.8 | 78.8 | < 0.001a |
| Sex (Female/Male) | 75 (41.0)/108 (59.0) | 105 (57.9)/77 (42.1) | 0.001a |
| Comorbidities | 99 (54.1) | 172 (94.0) | < 0.001a |
| Anticoagulation | 10 (5.5) | 81 (44.3) | < 0.001a |
| Glasgow coma scale, mean | 12.9 | 14.0 | 0.002a |
| Injury severity score, mean | 16.5 | 15.7 | 0.4 |
| Any blood transfusion | 71 (38.8) | 87 (47.5) | 0.1 |
| Co-injury types | - | - | - |
| Head | 52 (28.4) | 38 (20.8) | 0.1 |
| Spine | 27 (14.8) | 31 (16.9) | 0.6 |
| Thoracic | 31 (16.9) | 51 (27.9) | 0.01a |
| Abdominal | 34 (18.6) | 30 (16.4) | 0.6 |
| CT with contrast | 168 (90.8) | 149 (80.5) | 0.005a |
| Contrast blush | 29 (17.5) | 35 (24.5) | 0.1 |
| Pelvic angiogram | 29 (15.8) | 37 (20.2) | 0.3 |
| Pelvic embolization | 17 (58.6) | 26 (70.3) | 0.3 |
| Pelvic orthopedic surgery | 35 (19.1) | 14 (7.7) | 0.001a |
| Time: Admission to pelvic surgery, mean h | 37.9 | 20.2 | 0.1 |
| Exploratory laparotomy | 24 (13.1) | 19 (10.4) | 0.4 |
| ICU admission | 96 (52.5) | 114 (62.3) | 0.1 |
| ICU length of stay, mean days | 7.3 | 8.1 | 0.5 |
| Hospital length of stay, mean days | 11.9 | 9.1 | 0.04a |
| Do not resuscitate order | 6 (3.3) | 40 (21.9) | < 0.001a |
| Mortality | 7 (3.8) | 24 (13.1) | 0.001a |
| Hospital discharge disposition | - | - | < 0.001a |
| Expired in hospital | 5 (2.7) | 6 (3.3) | - |
| Hospice | 2 (1.1) | 18 (9.8) | - |
| Long term care hospital | 8 (4.4) | 11 (6.0) | - |
| Skilled nursing facility | 12 (6.6) | 59 (32.2) | - |
| Rehabilitation facility | 65 (35.5) | 68 (37.2) | - |
| Home | 91 (49.7) | 21 (11.5) | - |
Table 4 Comparison of patients with pelvic fractures with and without abdominal co-injuries, n (%)
| Variable | With abdominal co-injuries (n = 93) | Without abdominal co-injuries (n = 465) | P value |
| Age, mean | 56.0 | 63.3 | 0.003a |
| Geriatric | 35 (37.6) | 256 (55.1) | 0.002a |
| Sex (Female/Male) | 38 (40.9)/55 (59.1) | 246 (52.9)/219 (47.1) | 0.03a |
| Comorbidities | 65 (69.9) | 358 (77.0) | 0.1 |
| Mechanism of injury | - | - | < 0.001a |
| Fall | 13 (14.0) | 191 (41.1) | - |
| Motor vehicle | 76 (81.7) | 268 (57.6) | - |
| Glasgow coma scale, mean | 12.2 | 13.9 | < 0.001a |
| Injury severity score, mean | 27.4 | 13.3 | < 0.001a |
| AIS pelvis | - | - | < 0.001a |
| 2 | 43 (46.2) | 343 (73.8) | - |
| 3 | 13 (14.0) | 49 (10.5) | - |
| 4 | 20 (21.5) | 64 (13.8) | - |
| 5 | 17 (18.3) | 9 (1.9) | - |
| Any blood transfusion | 71 (76.4) | 150 (32.2) | < 0.001a |
| Co-injury types | - | - | - |
| Head | 25 (26.9) | 101 (21.7) | 0.3 |
| Spine | 22 (23.7) | 59 (12.7) | 0.006a |
| Thoracic | 34 (36.6) | 77 (16.6) | < 0.001a |
| CT with contrast | 90 (96.8) | 358 (77.0) | < 0.001a |
| Contrast blush | 41 (45.6) | 32 (8.9) | < 0.001a |
| Pelvic angiogram | 48 (51.6) | 54 (11.6) | < 0.001a |
| Pelvic embolization | 33 (68.8) | 28 (51.9) | 0.1 |
| Pelvic orthopedic surgery | 27 (29.0) | 47 (10.1) | < 0.001a |
| Exploratory laparotomy | 51 (54.8) | 13 (2.8) | < 0.001a |
| ICU admission | 83 (89.2) | 238 (51.2) | < 0.001a |
| ICU length of stay, mean days | 13.4 | 5.7 | < 0.001a |
| Hospital length of stay, mean days | 22.5 | 8.6 | < 0.001a |
| Mortality | 17 (18.3) | 23 (4.9) | < 0.001a |
| Hospital discharge disposition | - | - | < 0.001a |
| Expired in hospital | 9 (9.7) | 5 (1.1) | - |
| Hospice | 8 (8.6) | 18 (3.9) | - |
| Long term care hospital | 14 (15.1) | 12 (2.6) | - |
| Skilled nursing facility | 13 (14.0) | 113 (24.3) | - |
| Rehabilitation facility | 26 (28.0) | 166 (35.7) | - |
| Home | 23 (24.7) | 151 (32.5) | - |
Table 5 Comparison of propensity score matched by abbreviated injury score of pelvis, age and mechanism of injury patients with pelvic fractures with and without abdominal co-injuries, n (%)
| Variable | With abdominal co-injuries (n = 83) | Without abdominal co-injuries (n = 83) | P value |
| Age, mean | 56.6 | 54.8 | 0.3 |
| Mechanism of injury | - | - | 0.8 |
| Fall | 13 (15.7) | 13 (15.7) | - |
| Motor vehicle | 68 (81.9) | 69 (83.1) | - |
| AIS pelvis | - | - | 0.9 |
| 2 | 43 (51.8) | 42 (50.6) | - |
| 3 | 13 (15.7) | 16 (19.3) | - |
| 4 | 19 (22.9) | 17 (20.5) | - |
| 5 | 8 (9.6) | 8 (9.6) | - |
| Geriatric | 32 (38.6) | 32 (38.6) | 1.0 |
| Sex (Female/Male) | 36 (43.4)/47 (56.6) | 37 (44.6)/46 (55.4) | 0.9 |
| Comorbidities | 59 (71.1) | 56 (67.5) | 0.6 |
| Glasgow coma scale, mean | 12.4 | 13.3 | 0.1 |
| Injury severity score, mean | 25.6 | 17.5 | < 0.001a |
| Any blood transfusion | 62 (74.7) | 31 (37.3) | < 0.001a |
| Co-injury types | - | - | - |
| Head | 22 (26.5) | 17 (20.5) | 0.4 |
| Spine | 20 (24.1) | 11 (13.3) | 0.1 |
| Thoracic | 31 (37.3) | 16 (19.3) | 0.01a |
| CT with contrast | 80 (96.4) | 72 (86.7) | 0.02a |
| Contrast blush | 32 (40.0) | 11 (15.3) | < 0.001a |
| Pelvic angiogram | 39 (47.0) | 16 (19.3) | < 0.001a |
| Pelvic embolization | 25 (64.1) | 11 (68.8) | 0.7 |
| Pelvic orthopedic surgery | 19 (22.9) | 19 (22.9) | 1.0 |
| Time: Admission to pelvic surgery, mean h | 18.8 | 24.4 | 0.5 |
| Exploratory laparotomy | 45 (54.2) | 4 (4.8) | < 0.001a |
| ICU admission | 74 (89.2) | 50 (60.2) | < 0.001a |
| ICU length of stay, mean days | 13.1 | 6.3 | < 0.001a |
| Hospital length of stay, mean days | 22.0 | 11.0 | 0.002a |
| Mortality | 13 (15.7) | 4 (4.8) | 0.02a |
| Hospital discharge disposition | - | - | 0.04a |
| Expired in hospital | 7 (8.4) | 1 (1.2) | - |
| Hospice | 6 (7.2) | 3 (3.6) | - |
| Long term care hospital | 12 (14.5) | 4 (4.8) | - |
| Skilled nursing facility | 12 (14.5) | 17 (20.5) | - |
| Rehabilitation facility | 25 (30.1) | 29 (34.9) | - |
| Home | 21 (25.3) | 29 (34.9) | - |
Table 6 Comparison of patients with pelvic fractures with and without contrast blush, n (%)
| Variable | With contrast blush (n = 89) | Without contrast blush (n = 359) | P value |
| Age, mean | 61.0 | 57.7 | 0.2 |
| Geriatric | 45 (50.6) | 156 (43.5) | 0.2 |
| Sex (Female/Male) | 35 (39.3)/54 (60.7) | 182 (50.7)/177 (49.3) | 0.1 |
| Comorbidities | 66 (74.2) | 252 (70.2) | 0.5 |
| Mechanism of injury | - | - | 0.1 |
| Fall | 18 (20.2) | 104 (29.0) | - |
| Motor vehicle | 67 (75.3) | 250 (69.6) | - |
| Glasgow coma scale, mean | 12.9 | 13.5 | 0.2 |
| Injury severity score, mean | 24.1 | 15.0 | < 0.001a |
| AIS pelvis | 3.3 | 2.5 | < 0.001a |
| 2 | 39 (43.8) | 256 (71.3) | < 0.001a |
| 3 | 6 (6.7) | 48 (13.4) | - |
| 4 | 26 (29.2 | 48 (13.4) | - |
| 5 | 18 (20.2) | 7 (1.9) | - |
| Any blood transfusion | 71 (79.8) | 125 (34.8) | < 0.001a |
| Co-injury types | - | - | - |
| Head | 17 (19.1) | 88 (24.5) | 0.3 |
| Spine | 18 (20.2) | 50 (13.9) | 0.1 |
| Thoracic | 22 (24.7) | 80 (22.3) | 0.6 |
| Abdominal | 51 (57.3) | 39 (10.9) | < 0.001a |
| Pelvic angiogram | 67 (75.3) | 28 (7.8) | < 0.001a |
| Pelvic embolization | 45 (67.2) | 10 (35.7) | 0.005a |
| Pelvic orthopedic surgery | 31 (34.8) | 40 (11.1) | < 0.001a |
| Exploratory laparotomy | 33 (37.1) | 28 (7.8) | < 0.001a |
| ICU admission | 78 (87.6) | 197 (54.9) | < 0.001a |
| ICU length of stay, mean days | 11.6 | 7.1 | 0.003a |
| Hospital length of stay, mean days | 17.8 | 11.1 | 0.003a |
| Mortality | 16 (18.0) | 20 (5.6) | < 0.001a |
| Hospital discharge disposition | - | - | < 0.001a |
| Expired in hospital | 6 (6.7) | 6 (1.7) | - |
| Hospice | 10 (11.2) | 14 (3.9) | - |
| Long term care hospital | 13 (14.6) | 10 (2.8) | - |
| Skilled nursing facility | 19 (21.3) | 61 (17.0) | - |
| Rehabilitation facility | 23 (25.8) | 139 (38.7) | - |
| Home | 18 (20.2) | 129 (35.9) | - |
Table 7 Comparison of propensity score matched by abbreviated injury score of pelvis, age and abdominal co-injuries patients with pelvic fractures with and without contrast blush, n (%)
| Variable | With contrast blush (n = 73) | Without contrast blush (n = 73) | P value |
| Age, mean | 61.0 | 61.7 | 0.8 |
| AIS pelvis | - | - | 0.7 |
| 2 | 39 (53.4) | 44 (60.3) | - |
| 3 | 6 (8.2) | 5 (6.8) | - |
| 4 | 22 (30.1) | 21 (28.8) | - |
| 5 | 6 (8.2) | 3 (4.1) | - |
| Abdominal co-injuries | 35 (47.9) | 27 (37.0) | 0.2 |
| Geriatric | 37 (50.7) | 39 (53.4) | 0.7 |
| Sex (Female/Male) | 30 (41.1)/43 (58.9) | 36 (49.3)/37 (50.7) | 0.3 |
| Comorbidities | 56 (76.7) | 53 (72.6) | 0.6 |
| Mechanism of injury | - | - | 0.1 |
| Fall | 18 (24.7) | 29 (39.7) | - |
| Motor vehicle | 53 (72.6) | 43 (58.9) | - |
| Glasgow coma scale, mean | 13.0 | 13.2 | 0.7 |
| Injury severity score, mean | 20.6 | 19.5 | 0.5 |
| Any blood transfusion | 56 (76.7) | 32 (43.8) | < 0.001a |
| Co-injury types | - | - | - |
| Head | 16 (21.9) | 23 (31.5) | 0.1 |
| Spine | 14 (19.2) | 12 (16.4) | 0.7 |
| Thoracic | 16 (21.9) | 22 (30.1) | 0.3 |
| Pelvic angiogram | 52 (71.2) | 9 (12.3) | < 0.001a |
| Pelvic embolization | 33 (63.5) | 2 (22.2) | 0.02a |
| Pelvic orthopedic surgery | 22 (30.1) | 10 (13.7) | 0.02a |
| Exploratory laparotomy | 21 (28.8) | 13 (17.8) | 0.1 |
| ICU admission | 63 (86.3) | 47 (64.4) | 0.002a |
| ICU length of stay, mean days | 10.5 | 10.1 | 0.8 |
| Hospital length of stay, mean days | 17.0 | 18.1 | 0.8 |
| Mortality | 10 (13.7) | 8 (11.0) | 0.6 |
| Hospital discharge disposition | - | - | 0.9 |
| Expired in hospital | 3 (4.1) | 2 (2.7) | - |
| Hospice | 7 (9.6) | 6 (8.2) | - |
| Long term care hospital | 6 (8.2) | 3 (4.1) | - |
| Skilled nursing facility | 18 (24.7) | 16 (21.9) | - |
| Rehabilitation facility | 21 (28.8) | 24 (32.9) | - |
| Home | 18 (24.7) | 22 (30.1) | - |
- Citation: Fokin AA, Wycech Knight J, Tharp ME, Brinton KC, Gallagher PK, Xie JF, Weisz RD, Puente I. Pelvic fractures in blunt trauma patients: A comparative study. World J Orthop 2024; 15(5): 418-434
- URL: https://www.wjgnet.com/2218-5836/full/v15/i5/418.htm
- DOI: https://dx.doi.org/10.5312/wjo.v15.i5.418