Association of pelvic fracture patterns, pelvic binder use and arterial angio-embolization with transfusion requirements and mortality rates; a 7-year retrospective cohort study.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_BFD6A86ABF16
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Association of pelvic fracture patterns, pelvic binder use and arterial angio-embolization with transfusion requirements and mortality rates; a 7-year retrospective cohort study.
Périodique
BMC surgery
Auteur(s)
Agri F., Bourgeat M., Becce F., Moerenhout K., Pasquier M., Borens O., Yersin B., Demartines N., Zingg T.
ISSN
1471-2482 (Electronic)
ISSN-L
1471-2482
Statut éditorial
Publié
Date de publication
09/11/2017
Peer-reviewed
Oui
Volume
17
Numéro
1
Pages
104
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
Pelvic fractures are severe injuries with frequently associated multi-system trauma and a high mortality rate. The value of the pelvic fracture pattern for predicting transfusion requirements and mortality is not entirely clear. To address hemorrhage from pelvic injuries, the early application of pelvic binders is now recommended and arterial angio-embolization is widely used for controlling arterial bleeding. Our aim was to assess the association of the pelvic fracture pattern according to the Tile classification system with transfusion requirements and mortality rates, and to evaluate the correlation between the use of pelvic binders and arterial angio-embolization and the mortality of patients with pelvic fractures.
Single-center retrospective cohort study including all consecutive patients with a pelvic fracture from January 2008 to June 2015. All radiological fracture patterns were independently reviewed and grouped according to the Tile classification system. Data on patient demographics, use of pelvic binders and arterial angio-embolization, transfusion requirements and mortality were extracted from the institutional trauma registry and analyzed.
The present study included 228 patients. Median patient age was 43.5 years and 68.9% were male. The two independent observers identified 105 Tile C (46.1%), 71 Tile B (31.1%) and 52 Tile A (22.8%) fractures, with substantial to almost perfect interobserver agreement (Kappa 0.70-0.83). Tile C fractures were associated with a higher mortality rate (p = 0.001) and higher transfusion requirements (p < 0.0001) than Tile A or B fractures. Arterial angio-embolization for pelvic bleeding (p = 0.05) and prehospital pelvic binder placement (p = 0.5) were not associated with differences in mortality rates.
Tile C pelvic fractures are associated with higher transfusion requirements and a higher mortality rate than Tile A or B fractures. No association between the use of pelvic binders or arterial angio-embolization and survival was observed in this cohort of patients with pelvic fractures.

Mots-clé
Adult, Blood Transfusion, Embolization, Therapeutic, Female, Fractures, Bone/epidemiology, Hemorrhage/epidemiology, Humans, Male, Middle Aged, Pelvic Bones/injuries, Pelvis, Retrospective Studies, Arterial angio-embolization, Circumferential compression device, Mortality, Packed red blood cell transfusion, Pelvic fracture classification
Pubmed
Web of science
Open Access
Oui
Création de la notice
13/11/2017 13:41
Dernière modification de la notice
20/08/2019 16:34
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