| Autor: |
Duchesne JC; Department of Surgery and Anesthesia, Tulane University School of Medicine, New Orleans, LA 70112-2699, USA. jduchesn@tulane.edu, Bharmal HM, Dini AA, Islam T, Schmieg RE Jr, Simmons JD, Wahl GM, Davis JA Jr, Krause P, McSwain NE Jr |
| Jazyk: |
angličtina |
| Zdroj: |
The American surgeon [Am Surg] 2009 Dec; Vol. 75 (12), pp. 1227-33. |
| Abstrakt: |
Open-book pelvic fractures (OBPF) with concomitant intra-abdominal injuries carry a high morbidity and mortality; the significance of associated perineal open wound (OBPF-POW) has not been defined. We hypothesize that the presence of perineal open wounds increases morbidity, mortality, and concomitant use of hospital resources. Patients diagnosed with OBPF over a 5-year period at a Level I trauma center were identified by trauma registry review, and were retrospectively reviewed under an Institutional Review Board-approved protocol. Patients with OBPF without a perineal open wound were compared with those with OBPF-POW. Data collected included patient demographics, injury details, management, and outcomes. A total of 1,635 patients with blunt pelvic fractures were identified, of which 177 (10.8%) had OBPF. OBPF-POW (36/177) significantly increased the use of angioembolization, occurrence of sepsis, pelvic sepsis, ARDS, and multi-organ system failure. Patients with OBPF-POW had an increase of 13 days in length of hospitalization compared with the OBPF group (P < 0.001), with cost of $120,647.30 and $62,952.72 respectively (P < 0.001). Perineal open wounds complicate open-book pelvic fractures with significant increase in hospital resource utilization. Aggressive multidisciplinary evaluation and management is appropriate to detect and prevent complications. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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