Retrospective Cohort Study
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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. May 18, 2024; 15(5): 418-434
Published online May 18, 2024. doi: 10.5312/wjo.v15.i5.418
Table 1 General characteristics of patients with pelvic fractures, n (%)
Variable Patients with pelvic fractures (n = 558) Age, mean (SD) 62.0 (22.6) Geriatric 291 (52.2) Sex (Female/Male) 284 (50.9) / 274 (49.1) Comorbidities 423 (75.8) Anticoagulation 152 (27.2) Mechanism of injury - Fall 204 (36.6) Motor vehicle (Pedestrian/Bicycle/Motorcycle) 344 (61.6) Other (Assault, Crush) 10 (1.8) Glasgow coma scale, mean (SD) 13.7 (3.3) Injury severity score, mean (SD) 15.7 (10.7) AIS pelvis - 2 386 (69.2) 3 62 (11.1) 4 84 (15.1) 5 26 (4.7) Any blood transfusion 220 (39.6) Presence of co-injuries 286 (51.3) Co-Injury types - Head 126 (22.6) Spine 81 (14.5) Thoracic 111 (19.9) Abdominal 93 (16.7) CT with contrast 448 (80.3) Contrast blush 89 (19.9) Pelvic angiogram 102 (18.3) Pelvic embolization 61 (59.8) Pelvic orthopedic surgery 74 (13.3) Time: Admission to pelvic surgery, mean h 75.0 Exploratory laparotomy 64 (11.5) ICU admission 321 (57.5) ICU length of stay, mean days (SD) 7.7 (9.3) Hospital length of stay, mean days (SD) 10.9 (17.5) Do not resuscitate order 77 (13.8) Mortality 40 (7.2) Hospital discharge disposition - Expired in hospital 14 (2.5) Hospice 26 (4.7) Long term care hospital 26 (4.7) Skilled nursing facility 126 (22.6) Rehabilitation facility 192 (34.4) Home 174 (31.2)
Table 2 Comparison of non-geriatric and geriatric patients with pelvic fractures, n (%)
Variable Non-Geriatric (n = 267) Geriatric (n = 291) P valuesAge, mean 41.9 80.5 < 0.001a Sex (Female/Male) 109 (40.8) / 158 (59.2) 175 (60.1) / 116 (39.9) < 0.001a Comorbidities 145 (54.3) 278 (95.5) < 0.001a Anticoagulation 14 (5.2) 138 (47.4) < 0.001a Mechanism of injury - - < 0.001a Fall 48 (18.0) 156 (53.6) - Motor vehicle 211 (79.0) 133 (45.7) - Other 8 (3.0) 2 (0.7) - Glasgow coma scale, mean 12.9 14.3 < 0.001a Injury severity score, mean 17.5 14.0 < 0.001a AIS pelvis - - 0.01a 2 170 (63.7) 216 (74.2) - 3 39 (14.6) 23 (7.9) - 4 41 (15.4) 43 (14.8) - 5 17 (6.4) 9 (3.1) - Any blood transfusion 108 (40.4) 113 (38.8) 0.3 Co-injury types - - - Head 66 (24.7) 60 (20.6) 0.2 Spine 37 (13.9) 44 (15.1) 0.7 Thoracic 51 (19.1) 60 (20.6) 0.7 Abdominal 58 (21.7) 35 (12.0) 0.002a CT with contrast 247 (92.5) 201 (69.1) < 0.001a Contrast blush 37 (15.0) 36 (17.9) 0.4 Pelvic angiogram 50 (18.7) 52 (17.9) 0.8 Pelvic embolization 30 (60.0) 31 (59.6) 0.9 Pelvic orthopedic surgery 58 (21.7) 16 (5.5) < 0.001a Time: Admission to pelvic surgery, mean h 66.2 106.8 0.1 Exploratory laparotomy 44 (16.5) 20 (6.9) < 0.001a ICU Admission 152 (56.9) 169 (58.1) 0.8 ICU length of stay, mean days 8.9 6.6 0.03a Hospital length of stay, mean days 14.5 7.7 < 0.001a Do not resuscitate order 12 (4.5) 65 (22.3) < 0.001a Mortality 12 (4.5) 28 (9.6) 0.02a Hospital discharge disposition - - < 0.001a Expired in hospital 8 (3.0) 6 (2.1) - Hospice 4 (1.5) 22 (7.6) - Long term care hospital 13 (4.9) 13 (4.5) - Skilled nursing facility 18 (6.7) 108 (37.1) - Rehabilitation facility 91 (34.1) 101 (34.7) - Home 133 (49.8) 41 (14.1) -
Table 3 Comparison of propensity score matched by abbreviated injury score of pelvis and mechanism of injury non-geriatric and geriatric patients with pelvic fractures, n (%)
Variable Non-geriatric (n = 183) Geriatric (n = 183) P valueMechanism of injury - - 0.8 Fall 48 (26.2) 48 (26.2) - Motor vehicle 134 (73.2) 133 (72.7) - Other 1 (0.5) 2 (1.1) - AIS pelvis - - 0.9 2 124 (67.8) 127 (69.4) - 3 21 (11.5) 17 (9.3) - 4 29 (15.8) 30 (16.4) - 5 9 (4.9) 9 (4.9) - Age, mean 42.8 78.8 < 0.001a Sex (Female/Male) 75 (41.0)/108 (59.0) 105 (57.9)/77 (42.1) 0.001a Comorbidities 99 (54.1) 172 (94.0) < 0.001a Anticoagulation 10 (5.5) 81 (44.3) < 0.001a Glasgow coma scale, mean 12.9 14.0 0.002a Injury severity score, mean 16.5 15.7 0.4 Any blood transfusion 71 (38.8) 87 (47.5) 0.1 Co-injury types - - - Head 52 (28.4) 38 (20.8) 0.1 Spine 27 (14.8) 31 (16.9) 0.6 Thoracic 31 (16.9) 51 (27.9) 0.01a Abdominal 34 (18.6) 30 (16.4) 0.6 CT with contrast 168 (90.8) 149 (80.5) 0.005a Contrast blush 29 (17.5) 35 (24.5) 0.1 Pelvic angiogram 29 (15.8) 37 (20.2) 0.3 Pelvic embolization 17 (58.6) 26 (70.3) 0.3 Pelvic orthopedic surgery 35 (19.1) 14 (7.7) 0.001a Time: Admission to pelvic surgery, mean h 37.9 20.2 0.1 Exploratory laparotomy 24 (13.1) 19 (10.4) 0.4 ICU admission 96 (52.5) 114 (62.3) 0.1 ICU length of stay, mean days 7.3 8.1 0.5 Hospital length of stay, mean days 11.9 9.1 0.04a Do not resuscitate order 6 (3.3) 40 (21.9) < 0.001a Mortality 7 (3.8) 24 (13.1) 0.001a Hospital discharge disposition - - < 0.001a Expired in hospital 5 (2.7) 6 (3.3) - Hospice 2 (1.1) 18 (9.8) - Long term care hospital 8 (4.4) 11 (6.0) - Skilled nursing facility 12 (6.6) 59 (32.2) - Rehabilitation facility 65 (35.5) 68 (37.2) - Home 91 (49.7) 21 (11.5) -
Table 4 Comparison of patients with pelvic fractures with and without abdominal co-injuries, n (%)
Variable With abdominal co-injuries (n = 93) Without abdominal co-injuries (n = 465) P valueAge, mean 56.0 63.3 0.003a Geriatric 35 (37.6) 256 (55.1) 0.002a Sex (Female/Male) 38 (40.9)/55 (59.1) 246 (52.9)/219 (47.1) 0.03a Comorbidities 65 (69.9) 358 (77.0) 0.1 Mechanism of injury - - < 0.001a Fall 13 (14.0) 191 (41.1) - Motor vehicle 76 (81.7) 268 (57.6) - Glasgow coma scale, mean 12.2 13.9 < 0.001a Injury severity score, mean 27.4 13.3 < 0.001a AIS pelvis - - < 0.001a 2 43 (46.2) 343 (73.8) - 3 13 (14.0) 49 (10.5) - 4 20 (21.5) 64 (13.8) - 5 17 (18.3) 9 (1.9) - Any blood transfusion 71 (76.4) 150 (32.2) < 0.001a Co-injury types - - - Head 25 (26.9) 101 (21.7) 0.3 Spine 22 (23.7) 59 (12.7) 0.006a Thoracic 34 (36.6) 77 (16.6) < 0.001a CT with contrast 90 (96.8) 358 (77.0) < 0.001a Contrast blush 41 (45.6) 32 (8.9) < 0.001a Pelvic angiogram 48 (51.6) 54 (11.6) < 0.001a Pelvic embolization 33 (68.8) 28 (51.9) 0.1 Pelvic orthopedic surgery 27 (29.0) 47 (10.1) < 0.001a Exploratory laparotomy 51 (54.8) 13 (2.8) < 0.001a ICU admission 83 (89.2) 238 (51.2) < 0.001a ICU length of stay, mean days 13.4 5.7 < 0.001a Hospital length of stay, mean days 22.5 8.6 < 0.001a Mortality 17 (18.3) 23 (4.9) < 0.001a Hospital discharge disposition - - < 0.001a Expired in hospital 9 (9.7) 5 (1.1) - Hospice 8 (8.6) 18 (3.9) - Long term care hospital 14 (15.1) 12 (2.6) - Skilled nursing facility 13 (14.0) 113 (24.3) - Rehabilitation facility 26 (28.0) 166 (35.7) - Home 23 (24.7) 151 (32.5) -
Table 5 Comparison of propensity score matched by abbreviated injury score of pelvis, age and mechanism of injury patients with pelvic fractures with and without abdominal co-injuries, n (%)
Variable With abdominal co-injuries (n = 83) Without abdominal co-injuries (n = 83) P valueAge, mean 56.6 54.8 0.3 Mechanism of injury - - 0.8 Fall 13 (15.7) 13 (15.7) - Motor vehicle 68 (81.9) 69 (83.1) - AIS pelvis - - 0.9 2 43 (51.8) 42 (50.6) - 3 13 (15.7) 16 (19.3) - 4 19 (22.9) 17 (20.5) - 5 8 (9.6) 8 (9.6) - Geriatric 32 (38.6) 32 (38.6) 1.0 Sex (Female/Male) 36 (43.4)/47 (56.6) 37 (44.6)/46 (55.4) 0.9 Comorbidities 59 (71.1) 56 (67.5) 0.6 Glasgow coma scale, mean 12.4 13.3 0.1 Injury severity score, mean 25.6 17.5 < 0.001a Any blood transfusion 62 (74.7) 31 (37.3) < 0.001a Co-injury types - - - Head 22 (26.5) 17 (20.5) 0.4 Spine 20 (24.1) 11 (13.3) 0.1 Thoracic 31 (37.3) 16 (19.3) 0.01a CT with contrast 80 (96.4) 72 (86.7) 0.02a Contrast blush 32 (40.0) 11 (15.3) < 0.001a Pelvic angiogram 39 (47.0) 16 (19.3) < 0.001a Pelvic embolization 25 (64.1) 11 (68.8) 0.7 Pelvic orthopedic surgery 19 (22.9) 19 (22.9) 1.0 Time: Admission to pelvic surgery, mean h 18.8 24.4 0.5 Exploratory laparotomy 45 (54.2) 4 (4.8) < 0.001a ICU admission 74 (89.2) 50 (60.2) < 0.001a ICU length of stay, mean days 13.1 6.3 < 0.001a Hospital length of stay, mean days 22.0 11.0 0.002a Mortality 13 (15.7) 4 (4.8) 0.02a Hospital discharge disposition - - 0.04a Expired in hospital 7 (8.4) 1 (1.2) - Hospice 6 (7.2) 3 (3.6) - Long term care hospital 12 (14.5) 4 (4.8) - Skilled nursing facility 12 (14.5) 17 (20.5) - Rehabilitation facility 25 (30.1) 29 (34.9) - Home 21 (25.3) 29 (34.9) -
Table 6 Comparison of patients with pelvic fractures with and without contrast blush, n (%)
Variable With contrast blush (n = 89) Without contrast blush (n = 359) P valueAge, mean 61.0 57.7 0.2 Geriatric 45 (50.6) 156 (43.5) 0.2 Sex (Female/Male) 35 (39.3)/54 (60.7) 182 (50.7)/177 (49.3) 0.1 Comorbidities 66 (74.2) 252 (70.2) 0.5 Mechanism of injury - - 0.1 Fall 18 (20.2) 104 (29.0) - Motor vehicle 67 (75.3) 250 (69.6) - Glasgow coma scale, mean 12.9 13.5 0.2 Injury severity score, mean 24.1 15.0 < 0.001a AIS pelvis 3.3 2.5 < 0.001a 2 39 (43.8) 256 (71.3) < 0.001a 3 6 (6.7) 48 (13.4) - 4 26 (29.2 48 (13.4) - 5 18 (20.2) 7 (1.9) - Any blood transfusion 71 (79.8) 125 (34.8) < 0.001a Co-injury types - - - Head 17 (19.1) 88 (24.5) 0.3 Spine 18 (20.2) 50 (13.9) 0.1 Thoracic 22 (24.7) 80 (22.3) 0.6 Abdominal 51 (57.3) 39 (10.9) < 0.001a Pelvic angiogram 67 (75.3) 28 (7.8) < 0.001a Pelvic embolization 45 (67.2) 10 (35.7) 0.005a Pelvic orthopedic surgery 31 (34.8) 40 (11.1) < 0.001a Exploratory laparotomy 33 (37.1) 28 (7.8) < 0.001a ICU admission 78 (87.6) 197 (54.9) < 0.001a ICU length of stay, mean days 11.6 7.1 0.003a Hospital length of stay, mean days 17.8 11.1 0.003a Mortality 16 (18.0) 20 (5.6) < 0.001a Hospital discharge disposition - - < 0.001a Expired in hospital 6 (6.7) 6 (1.7) - Hospice 10 (11.2) 14 (3.9) - Long term care hospital 13 (14.6) 10 (2.8) - Skilled nursing facility 19 (21.3) 61 (17.0) - Rehabilitation facility 23 (25.8) 139 (38.7) - Home 18 (20.2) 129 (35.9) -
Table 7 Comparison of propensity score matched by abbreviated injury score of pelvis, age and abdominal co-injuries patients with pelvic fractures with and without contrast blush, n (%)
Variable With contrast blush (n = 73) Without contrast blush (n = 73) P valueAge, mean 61.0 61.7 0.8 AIS pelvis - - 0.7 2 39 (53.4) 44 (60.3) - 3 6 (8.2) 5 (6.8) - 4 22 (30.1) 21 (28.8) - 5 6 (8.2) 3 (4.1) - Abdominal co-injuries 35 (47.9) 27 (37.0) 0.2 Geriatric 37 (50.7) 39 (53.4) 0.7 Sex (Female/Male) 30 (41.1)/43 (58.9) 36 (49.3)/37 (50.7) 0.3 Comorbidities 56 (76.7) 53 (72.6) 0.6 Mechanism of injury - - 0.1 Fall 18 (24.7) 29 (39.7) - Motor vehicle 53 (72.6) 43 (58.9) - Glasgow coma scale, mean 13.0 13.2 0.7 Injury severity score, mean 20.6 19.5 0.5 Any blood transfusion 56 (76.7) 32 (43.8) < 0.001a Co-injury types - - - Head 16 (21.9) 23 (31.5) 0.1 Spine 14 (19.2) 12 (16.4) 0.7 Thoracic 16 (21.9) 22 (30.1) 0.3 Pelvic angiogram 52 (71.2) 9 (12.3) < 0.001a Pelvic embolization 33 (63.5) 2 (22.2) 0.02a Pelvic orthopedic surgery 22 (30.1) 10 (13.7) 0.02a Exploratory laparotomy 21 (28.8) 13 (17.8) 0.1 ICU admission 63 (86.3) 47 (64.4) 0.002a ICU length of stay, mean days 10.5 10.1 0.8 Hospital length of stay, mean days 17.0 18.1 0.8 Mortality 10 (13.7) 8 (11.0) 0.6 Hospital discharge disposition - - 0.9 Expired in hospital 3 (4.1) 2 (2.7) - Hospice 7 (9.6) 6 (8.2) - Long term care hospital 6 (8.2) 3 (4.1) - Skilled nursing facility 18 (24.7) 16 (21.9) - Rehabilitation facility 21 (28.8) 24 (32.9) - Home 18 (24.7) 22 (30.1) -