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Comparative Study
Pelvic fractures as a marker of injury severity in trauma patients.
- Roberto de Moraes Cordts Filho, José Gustavo Parreira, Jaqueline A Giannini Perlingeiro, Silvia C Soldá, Tércio de Campos, and José Cesar Assef.
- Department of Surgery, Faculdade de Ciência Médicas da Santa Casa de São Paulo, Emergency Service, Santa Casa de Misericordia de Sao Paulo.
- Rev Col Bras Cir. 2011 Sep 1; 38 (5): 310-6.
ObjectiveTo assess whether the presence of a pelvic fracture is associated with greater severity and worse prognosis in victims of blunt trauma.MethodsA retrospective analysis of protocols and records of victims of blunt trauma admitted from June 2008 to March 2009 was separated into two groups: those with pelvic fracture (Group I) and those without it (Group II). Data were collected from pre-hospital admission rates of trauma, laboratory tests, diagnosed lesions, treatment and outcome. We used the Student t test, Fisher's exact test and chi-square test for statistical analysis, considering p <0.05 as significant.ResultsDuring the study period, 2019 individuals had multiple trauma protocols completed, of which 43 (2.1%) had pelvic fractures. Patients in Group I had significantly lower average blood pressure, higher mean heart rate, lower mean Glasgow Coma Scale, the highest average AIS in the segments head, chest, abdomen and extremities, as well as higher mean ISS and lower mean TRISS and RTS on admission. Group I more frequently presented with traumatic subarachnoid hemorrhage (7% vs. 1.6%), spinal cord injury (9% vs. 1%), thoracic and abdominal injuries, as well as need for laparotomy (21% vs. 1 %), chest drainage (32% vs. 2%) and damage control (9% vs. 0%). Complications were more frequent in group I: ARDS (9% vs. 0%), persistent shock (30% vs. 1%), coagulopathy (23% vs. 1%), acute renal failure (21% vs. 0%) and death (28% vs. 2%).ConclusionThe presence of a pelvic fracture is a marker of greater severity and worse prognosis in victims of blunt trauma.
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