title: Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective.
abstract: BACKGROUND
  We wished to determine the characteristics of patients with pelvic ring fractures (PGs) in England and Wales, make comparisons to major trauma patients without pelvic injury (NPGs), and determine factors predicting mortality, including the impact of presence of pelvic reconstruction facilities in the receiving hospitals on outcome.
  
  
  METHODS
  Prospective data from 106 trauma receiving hospitals forming the Trauma Audit and Research Network were studied. Between January 1989 and December 2001 data of 159,746 trauma patients were collected in the Trauma Audit and Research Network database. Because of incomplete data, 1,610 pelvic fracture patients and 13,499 patients without pelvic fracture were excluded from detailed analysis. In total, 11,149 patients in the PG and the remaining 133,486 patients in the NPG (control) group were included in the final analysis.
  
  
  RESULTS
  There were statistically significantly more patients with an Injury Severity Score >15 in the PG group (n = 3,576; 32.1%) than in NPG group (n = 19,238; 14.4%) (p < 0.001), indicating that pelvic injuries were more often associated with other injuries. The majority of patients sustained Abbreviated Injury Score (AIS) 2 pelvic injuries (65.0%), whereas AIS 4 and 5 injuries were found in less than 10% of patients. Pelvic ring injuries were most commonly associated with chest trauma with >AIS 2 severity in 21.2% of the patients, head injuries (>AIS 2) in 16.9%, liver or spleen injuries in 8.0%, and two or more long bone fractures in 7.8%. The 3-month cumulative mortality rate of the patients with pelvic injuries was 14.2% (1,586 patients) versus 5.6% (7,465 patients) of the NPG group.
  
  
  CONCLUSIONS
  Age, early physiologic derangement, and presence of other injuries (head or trunk) were associated with reduced survival rates. When the expertise to deal with such a group of patients is not available, early transfer under safe conditions should be considered to improve survival rates.
authors: Department of Orthopaedics and Trauma, Leeds General Infirmary, Leeds, United Kingdom. pgiannoudi@aol.com
authors: Peter V
authors: PV
authors: Giannoudis
authors: Martin R W
authors: MR
authors: Grotz
authors: Christopher
authors: C
authors: Tzioupis
authors: Haralambos
authors: H
authors: Dinopoulos
authors: Gareth E
authors: GE
authors: Wells
authors: Otmar
authors: O
authors: Bouamra
authors: Fiona
authors: F
authors: Lecky
mesh_terms: D000328:Adult; D017677:Age Distribution; D015984:Causality; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology; D009985:Orthopedics / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D010384:Pelvic Bones / Q000293:injuries*; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D017678:Sex Distribution; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology