title: Pelvic ring fractures: has mortality improved following the implementation of damage control resuscitation?
abstract: BACKGROUND
  Over the last 10 years, the paradigm of damage control resuscitation (DCR) has been associated with improved patient outcomes. This study investigates the outcomes of both closed and open pelvic ring fractures at a single institution before and after the formal implementation of DCR principles.
  
  
  METHODS
  A retrospective chart review was performed in an urban level I trauma center of all patients who sustained open or closed pelvic ring fractures between 2002 and 2012.
  
  
  RESULTS
  Two thousand two hundred forty-seven patients presented with pelvic fractures between 2002 and 2012. Overall mortality was 10% (n = 212). Only 8% of all patients with closed fractures required DCR compared with 28% of patients with open fractures. There was no difference in mortality when comparing DCR and pre-DCR cohorts for either open or closed pelvic fractures.
  
  
  CONCLUSIONS
  Interestingly, although DCR seems to lead to more efficient initial resuscitations, further improvements in patient mortality were not realized with formal implementation of DCR principles.
authors.affiliation: Department of Surgery, Emory University and Grady Memorial Hospital, Atlanta, Ga, USA.
authors.forename: Caitlin A
authors.initials: CA
authors.lastname: Fitzgerald
authors.affiliation: Department of Surgery, Emory University and Grady Memorial Hospital, Atlanta, Ga, USA.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Morse
authors.affiliation: Department of Surgery, Emory University and Grady Memorial Hospital, Atlanta, Ga, USA. Electronic address: cdente@emory.edu.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Dente
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D002423:Cause of Death; D005260:Female; D050723:Fractures, Bone / Q000401:mortality* / Q000628:therapy; D005845:Georgia; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome
keywords: Damage control resuscitation; Patient mortality; Pelvic ring fractures