Effects of early use of external pelvic compression on transfusion requirements and mortality in pelvic fractures.
BACKGROUND
We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures.


METHODS
Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fracture in patients older than 55 years of age, or (3) fracture with systemic hypotension. Starting in November of 2003, EMC was performed using circumferential pelvic binders on patient arrival and continued for 24 to 72 hours. Patients who underwent EMC (n = 118) were compared with historical controls in the preceding year (n = 119).


RESULTS
Patients in the EMC and control groups had similar fracture patterns, age, and injury severity. EMC had no effect on mortality (23% vs 23%, P = .92), need for pelvic angioembolization (11% vs 15%, P = .35), or 24-hour transfusions (5.2 +/- 10 vs 4.6 +/- 9 U, P = .64).


CONCLUSIONS
Early EMC with pelvic binders does not reduce hemorrhage or mortality associated with pelvic fractures.
Ghaemmaghami
Vafa
V
Department of Surgery, Division of Burn, Trauma and Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Stop 9158, Dallas, TX 75390-9158, USA.
Sperry
Jason
J
Gunst
Mark
M
Friese
Randall
R
Starr
Adam
A
Frankel
Heidi
H
Gentilello
Larry M
LM
Shafi
Shahid
S
D001803:Blood Transfusion / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000401:mortality / Q000601:surgery*; D006489:Hemostatic Techniques; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D010388:Pelvis / Q000098:blood supply; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D011312:Pressure; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000601:surgery