title: Pelvic fracture classification: correlation with hemorrhage.
abstract: Hemorrhage remains the leading cause of death in patients with pelvic fractures. To identify patients at greatest risk for massive hemorrhage, we retrospectively reviewed charts and initial emergency room anterior-posterior (AP) radiographs of 245 consecutive patients. Pelvic fractures were classified according to our modification of the Pennel and Sutherland classification scheme. A simple pelvic fracture classification scheme was developed. Using this classification, we can be 90% confident that 50 to 69% of patients with "unstable" pelvic fractures will require 4 or more units of blood, 30 to 49% will require greater than 10 units of blood, 36 to 55% will have an intra-abdominal injury, and 6 to 18% will have a pelvic arterial injury. Therefore we conclude that this pelvic fracture classification based on the initial emergency-room AP X-ray can predict a patient population at high risk for massive hemorrhage for which an aggressive treatment protocol is justified.
authors.affiliation: Department of Surgery, University of Louisville, KY 40292.
authors.forename: H M
authors.initials: HM
authors.lastname: Cryer
authors.forename: F B
authors.initials: FB
authors.lastname: Miller
authors.forename: B M
authors.initials: BM
authors.lastname: Evers
authors.forename: L R
authors.initials: LR
authors.lastname: Rouben
authors.forename: D L
authors.initials: DL
authors.lastname: Seligson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004630:Emergencies; D050723:Fractures, Bone / Q000145:classification* / Q000150:complications / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014193:Trauma Centers