Pelvic trauma: What are the predictors of mortality and cardiac, venous thrombo-embolic and infectious complications following injury?
| Autor: | Julia O. Bader, Andrew J. Schoenfeld, Kenneth J. Nelson, William Arroyo, Philip J. Belmont |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Heart Diseases Poison control Disease Cohort Studies Fractures Bone Young Adult Risk Factors Internal medicine Injury prevention medicine Humans Shock Traumatic Hospital Mortality Young adult Pelvic Bones Aged Retrospective Studies General Environmental Science Aged 80 and over business.industry Age Factors Acetabulum Retrospective cohort study Venous Thromboembolism Middle Aged medicine.disease Surgery Blunt trauma Wound Infection Pelvic fracture General Earth and Planetary Sciences business Cohort study |
| Zdroj: | Injury. 44:1745-1749 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2013.08.007 |
| Popis: | Introduction This study sought to determine risk factors that influence mortality, cardiac events, venous thrombo-embolic disease (VTED), and infection following fractures of the pelvis and/or acetabulum. Methods The 2008 National Sample Program (NSP) of the National Trauma Databank was queried to identify all patients who sustained pelvic and acetabular fractures. Demographic data, injury-specific and surgical characteristics, and medical co-morbidities were abstracted. The occurrence of in-hospital mortality, cardiac events, VTED and infections were documented. Univariate testing, weighted logistic regression, and sensitivity analyses were performed to identify significant independent predictors of mortality and the complications under study. Results The NSP contained 41,297 cases of pelvic trauma. In-hospital mortality was documented in 3055 (7%) and one or more complications occurred in 6932 (17%). Cardiac events transpired in 2% of patients, VTED in 4% and infections in 3%. Increasing age, shock, time to procedure, ISS, and GCS were predictive of mortality. Cardiac events were found to be influenced by obesity, diabetes, ISS, GCS, age, and trauma mechanism. VTED was impacted by obesity, history of respiratory disease, male sex, ISS, GCS, medical co-morbidities, and time to procedure. Injuries caused by mechanisms other than blunt trauma, shock, age, ISS, GCS, medical co-morbidities, and time to procedure were associated with infection. Conclusions Several important predictors were identified for specific complications and mortality following pelvic trauma. The design of this study may render it more generalisable to American patients with pelvic injuries. Level of evidence II – Prognostic retrospective study of a prospective dataset. |
| Databáze: | OpenAIRE |
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