title: Predictors of early versus late mortality in pelvic trauma patients.
abstract: BACKGROUND
  Risks of predicting time-related in-hospital mortality varies in pelvic trauma patients. We aim to identify potential independent risks predictive of time-related (early versus late) mortality among pelvic trauma patients.
  
  
  METHODS
  Local trauma registry data from 2004 through 2013 were reviewed. Mortality causes and timing of death were investigated. Multivariate logistic regression identified independent risks predictive of early versus late mortality in pelvic trauma patients while adjusting for patient demographics (age, sex, race), clinical variables (initial vital signs, mental status, injury severity, associated injuries, comorbidities), and hospital outcomes (surgical interventions, crystalloid resuscitations, blood transfusions).
  
  
  RESULTS
  We retrospectively collected data on 1566 pelvic trauma patients with a mortality rate of 9.96% (156/1566). Approximately 74% of patients died from massive hemorrhage within the first 24 h of hospitalization (early mortality). Revised trauma score (RTS), injury severity score (ISS), initial hemoglobin, direct transfer to operating room, and blood transfusion administration in the Emergency Department were considered independent risk factors predictive of early mortality. Age, ISS, and Glasgow Coma Scale (GCS) were deemed risk factors predictive of death after 24 h (late mortality).
  
  
  CONCLUSIONS
  Given the fact of a substantial number of patients died within the first 24 h of hospital arrival, it is reasonable to consider the first 24 h of hospitalization as the appropriate window within which early mortality may be expected to occur in pelvic trauma patients. The risk factors associated with massive hemorrhage were strong predictors of early mortality, whereas late mortality predictors were more closely linked with comorbidities or in-hospital complications.
  
  
  CONCLUSIONS
  While risk factors predictive of early versus late mortality vary, ISS seems to predict both early and late mortality accurately in pelvic trauma patients.
authors.affiliation: Emergency Department, JPS Health Network, 1575 S. Main St, Fort Worth, TX, 76104, USA. HWang01@jpshealth.org.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Emergency Department, JPS Health Network, 1575 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Robinson
authors.affiliation: Research Institute, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Billy
authors.initials: B
authors.lastname: Moore
authors.affiliation: Emergency Department, JPS Health Network, 1575 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Kirk
authors.affiliation: Research Institute, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Jessica Laureano
authors.initials: JL
authors.lastname: Phillips
authors.affiliation: Emergency Department, JPS Health Network, 1575 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Johnbosco
authors.initials: J
authors.lastname: Umejiego
authors.affiliation: Emergency Department, JPS Health Network, 1575 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Chukwuma
authors.affiliation: Emergency Department, JPS Health Network, 1575 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Miller
authors.affiliation: University of South Florida, Morsani College of Medicine, 12901 Bruce B. Downs Blvd., MDC061, Tampa, FL, 33612-4799, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Hassani
authors.affiliation: Research Institute, JPS Health Network, 1500 S. Main St, Fort Worth, TX, 76104, USA.
authors.forename: Nestor R
authors.initials: NR
authors.lastname: Zenarosa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D010388:Pelvis / Q000293:injuries*; D012042:Registries; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*
keywords: Mortality; Pelvic trauma; Predictors; Time-related