title: Comparing the predictive value of the pelvic ring injury classification systems by Tile and by Young and Burgess.
abstract: BACKGROUND
  Radiology-based classifications of pelvic ring injuries and their relevance for the prognosis of morbidity and mortality are disputed in the literature. The purpose of this study was to evaluate potential differences between the pelvic ring injury classification systems by Tile and by Young and Burgess with regard to their predictive value on mortality, transfusion/infusion requirement and concomitant injuries.
  
  
  METHODS
  Two-hundred-and-eighty-five consecutive patients with pelvic ring fractures were analyzed for mortality within 30 days after admission, number of blood units and total volume of fluid infused during the first 24h after trauma, the Abbreviated Injury Severity (AIS) scores for head, chest, spine, abdomen and extremities as a function of the Tile and the Young-Burgess classifications.
  
  
  RESULTS
  There was no significant relationship between occurrence of death and fracture pattern but a significant relationship between fracture pattern and need for blood units/total fluid volume for Tile (p<.001/p<.001) and Young-Burgess (p<.001/p<.001). In both classifications, open book fractures were associated with more fluid requirement and more severe injuries of the abdomen, spine and extremities (p<.05). When divided into the larger subgroups "partially stable" and "unstable", unstable fractures were associated with a higher mortality rate in the Young-Burgess system (p=.036). In both classifications, patients with unstable fractures required significantly more blood transfusions (p<.001) and total fluid infusion (p<.001) and higher AIS scores.
  
  
  CONCLUSIONS
  In this first direct comparison of both classifications, we found no clinical relevant differences with regard to their predictive value on mortality, transfusion/infusion requirement and concomitant injuries.
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland. Electronic address: georg.osterhoff@usz.ch.
authors.forename: Georg
authors.initials: G
authors.lastname: Osterhoff
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Scheyerer
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Fritz
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland.
authors.forename: Samy
authors.initials: S
authors.lastname: Bouaicha
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland.
authors.forename: Guido A
authors.initials: GA
authors.lastname: Wanner
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Simmen
authors.affiliation: Division of Trauma Surgery, University Hospital Zurich, Switzerland.
authors.forename: Clément M L
authors.initials: CM
authors.lastname: Werner
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004635:Emergency Medicine; D005260:Female; D050723:Fractures, Bone / Q000145:classification* / Q000401:mortality / Q000473:pathology; D005597:Fractures, Open / Q000145:classification* / Q000401:mortality / Q000473:pathology; D017052:Hospital Mortality; D006801:Humans; D007813:Laparotomy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D010384:Pelvic Bones / Q000293:injuries* / Q000473:pathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000145:classification* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices
keywords: Pelvic ring fractures; Pelvic ring injuries; Tile classification; Young–Burgess classification