title: Pelvic fractures at a new level 1 trauma centre: who dies from pelvic trauma? The Inkosi Albert Luthuli Central Hospital experience.
abstract: OBJECTIVE
  To identify the incidence of pelvic trauma, causes of death and factors predicting death with pelvic fractures.
  
  
  METHODS
  All pelvic fractures were retrospectively identified from a registry spanning from March 2007 to August 2009. Data was captured on a proforma. Data for survivors, non-survivors and a subgroup with pelvic injury as the underlying cause of death were compared.
  
  
  RESULTS
  Pelvic fracture incidence was 16% of major trauma cases. Patient with pelvic fractures had 31% mortality and 9% pelvic fracture-induced mortality. Motor vehicle collisions were the commonest external cause of pelvic fractures (59%); however, the highest mortality was from falls >6 m. The Injury Severity Score (ISS) was 29 in survivors, 36 in non-survivors, and 54 in the pelvic death subgroup. Type C fracture was a predictor of mortality (P = 0.135). 53% of the cases required transfusion in the first 24 hours. The pelvic death subgroup received a mean of 10.7 units of blood, versus 4 units for survivors and 3.7 units for non-survivors (P = 0.259).
  
  
  CONCLUSIONS
  The overall incidence of pelvic fracture and associated mortality were higher than previously reported. Fracture severity and falls from heights are associated with additional injuries (higher ISS) and mortality. More severe fractures cause deaths directly attributable to the pelvic injury. The requirement for major blood transfusions for pelvic fracture hemorrhage was related to mortality. Female patients appeared to fare worse than males.
authors.affiliation: Medical School, Umea University, Umea, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Palmcrantz
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Hardcastle
authors.forename: Steven R
authors.initials: SR
authors.lastname: Naidoo
authors.forename: David J J
authors.initials: DJ
authors.lastname: Muckart
authors.forename: Kristin
authors.initials: K
authors.lastname: Ahlm
authors.forename: Anders
authors.initials: A
authors.lastname: Eriksson
mesh_terms: D000058:Accidental Falls / Q000401:mortality; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D014193:Trauma Centers; D016896:Treatment Outcome; D055815:Young Adult