title: Does Severity of Pelvic Fractures Correlate with the Incidence of Associated Intra-Abdominal Injuries in Children?
abstract: Background Pelvic fractures are considered a marker of injury severity, especially in the pediatric population. However, the correlation between the severity of pelvic fractures and incidence of associated abdominal injuries is not clear. Methods A retrospective cohort study involving blunt trauma patients up to the age of 14 years, who suffered from pelvic fractures, with or without associated intra-abdominal injuries. Results A total of 812 trauma patients were included in this study. Overall, 671 of them suffered from pelvic fractures with abbreviated injury scale (AIS) of 2, 103 with AIS of 3, and 38 with AIS of 4 to 5. Overall mortality was found to be 5.2%, strongly correlating with the severity of the pelvic fractures (p value < 0.0001). There was no correlation between the incidence of most extrapelvic abdominal organ injuries (liver, spleen, small bowel, and pancreas) and the severity of pelvic fractures. A significant correlation was found with intrapelvic organ injuries (p value < 0.0001) and kidney injuries (p = 0.03). Conclusions Mortality of pediatric trauma patients with pelvic fractures is correlated with the severity of the fractures. An increase in the severity of pelvic fractures in this population is associated with an increased incidence of pelvic organ injury, but is not associated with the presence of extrapelvic abdominal injuries, except for kidney injuries.
authors.affiliation: Department of Surgery, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Forat
authors.initials: F
authors.lastname: Swaid
authors.affiliation: National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
authors.forename: Kobi
authors.initials: K
authors.lastname: Peleg
authors.affiliation: Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Alfici
authors.affiliation: ShaareZedek Medical Center, Jerusalem, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Olsha
authors.affiliation: National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Givon
authors.affiliation: Trauma Unit, Hillel Yaffe Medical Center, Hadera, Israel.
authors.forename: Boris
authors.initials: B
authors.lastname: Kessel
mesh_terms: D015998:Abbreviated Injury Scale; D000007:Abdominal Injuries / Q000453:epidemiology* / Q000401:mortality; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D050723:Fractures, Bone / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007557:Israel / Q000453:epidemiology; D007668:Kidney / Q000293:injuries; D009104:Multiple Trauma / Q000453:epidemiology* / Q000401:mortality; D010384:Pelvic Bones / Q000293:injuries*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000401:mortality