Pelvic fractures: an analysis of factors affecting prehospital triage and patient outcome.
Using an established prehospital regional triage protocol, 175 patients sustaining fractures of the pelvis were managed in a level one trauma center during a 38-month interval. The majority of injuries (51.7%) were caused by motor vehicle accidents and involved an average trauma score (TS) of 13 and an average injury severity score (ISS) of 24. The overall mortality was 16%; 43.5% had open fractures, 13.2% had closed fractures, and 30.6% had been in pedestrian accidents. Significant risk factors for mortality were age, blood pressure on admission, associated injuries, and the presence of an open pelvic fracture. It appears that TS alone is not reliable in prehospital triage of patients with pelvic fractures. Age and mechanism of injury may better identify the patient at risk for morbidity and mortality.
Fox
M A
MA
Presley Memorial Trauma Center, University of Tennessee, Memphis.
Mangiante
E C
EC
Fabian
T C
TC
Voeller
G R
GR
Kudsk
K A
KA
D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D001794:Blood Pressure; D002423:Cause of Death; D004632:Emergency Medical Services; D005069:Evaluation Studies as Topic; D005260:Female; D005596:Fractures, Closed / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D005597:Fractures, Open / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy; D010043:Outcome and Process Assessment, Health Care; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D013997:Time Factors; D014218:Triage