Predictors of mortality for complex fractures of the pelvic ring in the elderly: a twelve-year review from a German level I trauma center.
OBJECTIVE
To document mortality rate and predictors of mortality in elderly patients with complex pelvic fractures.


METHODS
We reviewed a total of 84 subjects whose ages were above 70 years with complex pelvic fractures, admitted to our hospital from January 2001 to December 2012. A multivariate linear regression model was used to determine the predictors of mortality in the study population. The median age of the patients was 80.4 years (range 70-94 years). 65 of 84 (77%) patients were females. There were 72 Tile Type B fractures (86%) and 12 Type C fractures (14%). The most common associated injuries were thoracic, extremity and head injuries, with incidence of 13 (15%), 11 (13%), and 9 (11%), respectively.


RESULTS
The mortality rate was 10% in our study population. The initial haemoglobin on admission (p<0.01), the presence of blood vessel injuries (p<0.01) and the number of PRBCs transfused within the first six hours after admission (p<0.01) independently predicted mortality in elderly patients with complex pelvic fractures.


CONCLUSIONS
Although there is a downward trend in mortality in elderly patients with complex pelvic fractures, haemodynamic instability still has a significant impact on survival of those patients.
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany; Department of Orthopedic and Trauma Surgery, Cedarcrest Hospital, 37 Oladipo Bateye Street, 23401 Lagos, Nigeria.
Ishaq
I
Ojodu
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany.
Tim
T
Pohlemann
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany.
Sascha
S
Hopp
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany.
Mika F R
MF
Rollmann
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany.
Joerg H
JH
Holstein
Department of Trauma, Hand, and Reconstructive Surgery, University of Saarland, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany. Electronic address: steven.herath@uks.eu.
Steven C
SC
Herath
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000401:mortality* / Q000601:surgery; D005858:Germany / Q000453:epidemiology; D006439:Hemodynamics; D006470:Hemorrhage / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D006489:Hemostatic Techniques / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000150:complications* / Q000401:mortality* / Q000601:surgery; D010384:Pelvic Bones / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014193:Trauma Centers / Q000706:statistics & numerical data; D016896:Treatment Outcome
Elderly; Mortality; Pelvic fracture; Predictors