title: Patients with pelvic fractures from blunt trauma. What is the cause of mortality and when?
abstract: BACKGROUND
  Mortality in patients sustaining pelvic fractures has been reported to be 4% to 15%. We sought to investigate the cause of death based on timing and evaluate if type of fracture and Injury Severity Score have an influence on the survival time.
  
  
  METHODS
  Sixty-nine patients of eight hundred sixty seven with a pelvic fracture who died during their hospital admission were included. Fractures were classified using the Arbeitsgemeinschaft Osteosynthesefragen/Orthopaedic Trauma Association system. Cause determined by autopsy in 48/69.
  
  
  RESULTS
  The leading cause of death within 6 hours was abdominal and pelvic hemorrhage; 6 to 24 hours head injury, and greater than 24 hours multiple organ dysfunction syndrome. Survival time did not correlate between fracture type (P < .12) or Injury Severity Score. Only 2 patients died of isolated pelvic hemorrhage.
  
  
  CONCLUSIONS
  Despite the advances made in acute management of the traumatized patient in the emergency department, mortality is unavoidable in a small group of patients with hemorrhage being the commonest cause of early death but isolated pelvic hemorrhage rare.
authors.affiliation: 4G University Health Centre, Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201, USA. Electronic address: rahvaidya2012@gmail.com.
authors.forename: Rahul
authors.initials: R
authors.lastname: Vaidya
authors.affiliation: 4G University Health Centre, Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201, USA.
authors.forename: Alesha N
authors.initials: AN
authors.lastname: Scott
authors.affiliation: 4G University Health Centre, Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Tonnos
authors.affiliation: 4G University Health Centre, Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201, USA.
authors.forename: Ian
authors.initials: I
authors.lastname: Hudson
authors.affiliation: 4G University Health Centre, Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Martin
authors.affiliation: 4G University Health Centre, Detroit Receiving Hospital, 4201 St. Antoine Blvd, Detroit, MI 48201, USA.
authors.forename: Anil
authors.initials: A
authors.lastname: Sethi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012307:Risk Factors; D015996:Survival Rate; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000401:mortality* / Q000628:therapy
keywords: Mortality; Pelvic fracture; Survival time