title: Epidemiology of Blunt Lower Urinary Tract Trauma With and Without Pelvic Fracture.
abstract: OBJECTIVE
  To assess the contemporary epidemiology of blunt trauma lower urinary tract injury (LUTI) and to evaluate outcomes in patients with and without associated pelvic fracture (PF).
  
  
  METHODS
  Patients presenting to our level I trauma center with PF and/or LUTI from blunt trauma from 2000 to 2014 were identified in our institutional trauma registry. Demographics, mechanism of injury, fracture configurations, hospital course, and outpatient disposition were analyzed.
  
  
  RESULTS
  Of 5518 PF patients, 233 (4.2%) had LUTI. Thirty-four patients had non-PF LUTI. There were 3.2% of men and 3.3% of women with PF who had bladder injuries (P = .94). Urethral injury was more common in men (2.0% vs 0.05%; relative risk 43.1). Pubic arch fractures were present in 87% of patients with urethral injuries, although only 1.5% of patients with pubic arch fractures had urethral injury. Isolated acetabular fractures were never associated with urethral injury and associated with only 2.6% of bladder injuries. Extraperitoneal bladder ruptures were more common in the PF group as compared to the non-PF LUTI group (39.1% vs 14.7%, P < .01). Intensive care unit length of stay and hospital length of stay for PF vs non-PF patients were 7.1 ± 8.1 vs 2.8 ± 5.3 days (P < .01) and 13.5 ± 13.4 vs 7.7 ± 8.4 days (P = .01), respectively.
  
  
  CONCLUSIONS
  These data suggest that the contemporary incidence of PF LUTI is lower than previously reported. The presence of PF in patients with LUTI is associated with more severe overall injuries, longer hospital stays, and increased rates of inpatient complications.
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: niels.v.johnsen@vanderbilt.edu.
authors.forename: Niels V
authors.initials: NV
authors.lastname: Johnsen
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dmochowski
authors.affiliation: Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Young
authors.affiliation: Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Guillamondegui
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012737:Sex Factors; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014551:Urinary Tract / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000453:epidemiology*