title: Predictors of mortality among initially stable adult pelvic trauma patients in the US: Data analysis from the National Trauma Data Bank.
abstract: OBJECTIVE
  Pelvic fractures are associated with increased risk of death among trauma patients. Studies show independent risks predicting mortality among patients with pelvic fractures vary across different geographic regions. This study analyses national data to determine predictors of mortality in initially stable adult pelvic trauma patients in the US.
  
  
  METHODS
  This study is a retrospective analysis of the US National Trauma Data Bank from January 2003 to December 2010 among trauma patients ≥18 years of age with pelvic fractures (including acetabulum). Over 150 variables were reviewed and analysed. The primary outcome was all-cause in-hospital mortality. Logistic regression analysis was used to determine independent risk factors predictive of in-hospital mortality in stable pelvic fracture patients.
  
  
  RESULTS
  30,800 patients were included in the final analysis. Overall in-hospital mortality rate was 2.7%. Mortality increased twofold in middle aged patients (age 55-70), and increased nearly fourfold in patients with advanced age ≥70. We found patients with advanced age, higher severity of injury, Glasgow Coma Scale (GCS) <8, GCS between 9 and 12, prolonged mechanical ventilation, and/or in-hospital blood product administration experienced higher mortality. Patients transported to level 1 or level 2 trauma centres experienced lower mortality while concomitantly experiencing higher associated internal injuries.
  
  
  CONCLUSIONS
  Geriatric and middle aged pelvic fracture patients experience higher mortality. Predictors of mortality in initially stable pelvic fracture patients are advanced age, injury severity, mental status, prolonged mechanical ventilation, and/or in-hospital blood product administration. These patients might benefit from transport to local level 1 or level 2 trauma centres.
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States. Electronic address: hwang01@jpshealth.org.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Surgery, Research Institute, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: J Laureano
authors.initials: JL
authors.lastname: Phillips
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Robinson
authors.affiliation: Department of Surgery, Research Institute, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Therese M
authors.initials: TM
authors.lastname: Duane
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Stefan
authors.initials: S
authors.lastname: Buca
authors.affiliation: Department of Surgery, Research Institute, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Mackenzie B
authors.initials: MB
authors.lastname: Campbell-Furtick
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Adam
authors.initials: A
authors.lastname: Jennings
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Tyler
authors.initials: T
authors.lastname: Miller
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Nestor R
authors.initials: NR
authors.lastname: Zenarosa
authors.affiliation: Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, 1500 S. Main St., Fort Worth, TX 76104, United States.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Delaney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D050723:Fractures, Bone / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Age; Mortality; National Trauma Data Bank; Predictors; Stable pelvic fractures