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https://hdl.handle.net/1/1900
Title: | The epidemiology of pelvic ring fractures: a population-based study | Authors: | Mackay, Peter ;Balogh, Z.;King, K.L.;McDougall, D.;MacKenzie, S.;Evans, J.A.;Lyons, T.;Deane, S.A. | Issue Date: | Nov-2007 | Source: | Volume 63, Issue 5, pp. 1066 - 1073 | Journal title: | The Journal of Trauma | Department: | Nursing & Midwifery Directorate | Abstract: | BACKGROUND: The severity of pelvic ring fractures (PRFs) can range from minor injury with low-energy mechanism to high-energy injury causing prehospital death. The purpose of this study was to prospectively describe the comprehensive pelvic fracture occurrence in an inclusive trauma system. METHODS: A 12-month prospective, population-based epidemiologic study was performed in the Hunter Region, New South Wales, Australia (population of 600,000, served by one Level I trauma center and 7 referring hospitals). Patient demographics, mechanism, injury severity, shock parameters, and outcomes were recorded prospectively. The database included all pelvic fractures from the region: high-energy pelvic fractures (HE-PRFs), low-energy pelvic fractures (LE-PRFs), and prehospital deaths (PD-PRFs). RESULTS: The incidence of PRF in the trauma system was 23 per 100,000 persons (138 fractures). The incidences of HE-PRF and LE-PRF were each 10 per 100,000 persons, whereas there were 3 PD-PRFs per 100,000. HE-PRF compared with LE-PRF occurred predominantly in men (64% vs. 20%, p < 0.05), younger persons (41 +/- 3 vs. 83 +/- 1 years, p < 0.05), those who had a higher Injury Severity Score (23 +/- 3 vs. 6 +/- 1, p < 0.05), and those with lower blood pressure (111 +/- 1 mm Hg vs. 153 +/- 1 mm Hg, p < 0.05), but the inhospital mortality rate was not statistically different (15% vs. 8%, p = NS). The overall mortality of the cohort was 23% (60% of those were from the PD-PRF group). The PRF-related mortality was 7% (HE-PRF: 7%; LE-PRF: 2%; PD-PRF: 33%), which was always attributable to bleeding. The incidence of demonstrated pelvic fracture-related arterial bleeding was 1.3 per 100,000 persons per year. CONCLUSIONS: LE-PRF and HE-PRF are equally frequent among hospital admissions. They represent two distinct demographic groups with similar mortality rate. Most PRF-related deaths occur prehospitally. Bleeding remains the primary cause of PRF-related mortality in all groups. | URI: | https://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1900 | DOI: | 10.1097/TA.0b013e3181589fa4 | Pubmed: | https://pubmed.ncbi.nlm.nih.gov/17993952/ | ISSN: | 0022-5282 | Publicaton type: | Journal Article | Keywords: | Child Newborn and Infant Aged |
Study or Trial: | Prospective Cohort Study |
Appears in Collections: | Health Service Research |
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