[Complex pelvic traumas : data linkage of the German Pelvic Injury Register and the TraumaRegister DGU®].
BACKGROUND
Complex pelvic traumas, i.e., pelvic fractures accompanied by pelvic soft tissue injuries, still have an unacceptably high mortality rate of about 18 %.


METHODS
We retrospectively evaluated an intersection set of data from the TraumaRegister DGU® and the German Pelvic Injury Register from 2004-2009. Patients with complex and noncomplex pelvic traumas were compared regarding their vital parameters, emergency management, stay in the ICU, and outcome.


RESULTS
From a total of 344 patients with pelvic injuries, 21 % of patients had a complex and 79 % a noncomplex trauma. Complex traumas were significantly less likely to survive (16.7 % vs. 5.9 %). Whereas vital parameters and emergency treatment in the preclinical setting did not differ substantially, patients with complex traumas were more often in shock and showed acute traumatic coagulopathy on hospital arrival, which resulted in more fluid volumes and transfusions when compared to patients with noncomplex traumas. Furthermore, patients with complex traumas had more complications and longer ICU stays.


CONCLUSIONS
Prevention of exsanguination and complications like multiple organ dysfunction syndrome still pose a major challenge in the management of complex pelvic traumas.
Abteilung für Chirurgie, Schwerpunkt Unfallchirurgie und Orthopädie, Handchirurgie, Evangelisches Stadtkrankenhaus Saarbrücken, Großherzog-Friedrich-Straße 44, 66111, Saarbrücken, Deutschland. Mac.Burkhardt@t-online.de.
M
M
Burkhardt
AUC - Akademie der Unfallchirurgie GmbH, München, Deutschland.
U
U
Nienaber
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.
J
J
Krause
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.
A
A
Pizanis
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.
P
P
Moersdorf
Klinik für Unfallchirurgie, Allgemeines Krankenhaus Celle, Celle, Deutschland.
U
U
Culemann
Institut für Evaluative Forschung in der Medizin, Universität Bern, Bern, Schweiz.
E
E
Aghayev
Lehrstuhl für Orthopädie, Unfallchirurgie und Sporttraumatologie, Universitätsklinikum Witten/Herdecke, Klinikum Köln-Merheim, Köln, Deutschland.
T
T
Paffrath
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.
T
T
Pohlemann
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland.
J H
JH
Holstein
D000328:Adult; D001803:Blood Transfusion / Q000401:mortality / Q000706:statistics & numerical data; D015897:Comorbidity; D004211:Disseminated Intravascular Coagulation / Q000401:mortality; D005260:Female; D005440:Fluid Therapy / Q000401:mortality / Q000706:statistics & numerical data; D050723:Fractures, Bone / Q000401:mortality* / Q000628:therapy*; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008498:Medical Record Linkage; D009104:Multiple Trauma / Q000401:mortality* / Q000628:therapy*; D010388:Pelvis / Q000293:injuries*; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D012769:Shock / Q000401:mortality; D015996:Survival Rate; D014194:Traumatology / Q000706:statistics & numerical data
Emergency management; Mortality; Pelvic fracture; Pelvic trauma, complex; Registry