Factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma: A retrospective study

Myoung Jun Kim, Jae Gil Lee, Seung Hwan Lee

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Blunt pelvic injuries are often associated with pelvic fractures and injuries to the rectum and genitourinary tract. Pelvic fractures can lead to life-threatening hemorrhage, which is a common cause of morbidity and mortality in trauma. Thus, early identification of patients with pelvic fractures at risk severe bleeding requiring urgent hemorrhage control is crucial. This study aimed to investigate early factors predicting the need for hemorrhage control in blunt pelvic trauma. Methods: The medical records of 1760 trauma patients were reviewed retrospectively between January 2013 and June 2018. We enrolled 187 patients with pelvic fracture due to blunt trauma who were older than 15 years. The pelvic fracture pattern was classified according to the Orthopedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen (OTA/AO) classification. A multivariate logistic regression model was used to determine independent predictors of the need for pelvic hemorrhage control intervention. Results: The most common pelvic fracture pattern was type A (54.5%), followed by types B (36.9%) and C (8.6%). Of 187 patients, 48 (25.7%) required pelvic hemorrhage control intervention. Hemorrhage control interventions were most frequently performed in patients with type B fractures (54.2%). Multivariate logistic regression analysis revealed that type B (odds ratio [OR] = 4.024, 95% confidence interval [CI] = 1.666-9.720, p = 0.002) and C (OR = 7.077, 95% CI = 1.781-28.129, p = 0.005) fracture patterns, decreased body temperature (OR = 2.275, 95% CI = 0.134-0.567, p < 0.001), and elevated serum lactate level (OR = 1.234, 95% CI = 1.061-1.435, p = 0.006) were factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma. Conclusion: Patients with type B and C fracture patterns on the OTA/AO classification, hypothermia, or an elevated serum lactate level are at risk for bleeding and require pelvic hemorrhage control intervention.

Original languageEnglish
Article number438
JournalBMC Surgery
Volume18
Issue number1
DOIs
Publication statusPublished - 2018 Nov 16

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Retrospective Studies
Hemorrhage
Wounds and Injuries
Odds Ratio
Confidence Intervals
Logistic Models
Orthopedics
Lactic Acid
Nonpenetrating Wounds
Hypothermia
Body Temperature
Serum
Rectum
Medical Records
Regression Analysis
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{332efadec7f6434593a678813989c995,
title = "Factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma: A retrospective study",
abstract = "Background: Blunt pelvic injuries are often associated with pelvic fractures and injuries to the rectum and genitourinary tract. Pelvic fractures can lead to life-threatening hemorrhage, which is a common cause of morbidity and mortality in trauma. Thus, early identification of patients with pelvic fractures at risk severe bleeding requiring urgent hemorrhage control is crucial. This study aimed to investigate early factors predicting the need for hemorrhage control in blunt pelvic trauma. Methods: The medical records of 1760 trauma patients were reviewed retrospectively between January 2013 and June 2018. We enrolled 187 patients with pelvic fracture due to blunt trauma who were older than 15 years. The pelvic fracture pattern was classified according to the Orthopedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen (OTA/AO) classification. A multivariate logistic regression model was used to determine independent predictors of the need for pelvic hemorrhage control intervention. Results: The most common pelvic fracture pattern was type A (54.5{\%}), followed by types B (36.9{\%}) and C (8.6{\%}). Of 187 patients, 48 (25.7{\%}) required pelvic hemorrhage control intervention. Hemorrhage control interventions were most frequently performed in patients with type B fractures (54.2{\%}). Multivariate logistic regression analysis revealed that type B (odds ratio [OR] = 4.024, 95{\%} confidence interval [CI] = 1.666-9.720, p = 0.002) and C (OR = 7.077, 95{\%} CI = 1.781-28.129, p = 0.005) fracture patterns, decreased body temperature (OR = 2.275, 95{\%} CI = 0.134-0.567, p < 0.001), and elevated serum lactate level (OR = 1.234, 95{\%} CI = 1.061-1.435, p = 0.006) were factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma. Conclusion: Patients with type B and C fracture patterns on the OTA/AO classification, hypothermia, or an elevated serum lactate level are at risk for bleeding and require pelvic hemorrhage control intervention.",
author = "Kim, {Myoung Jun} and Lee, {Jae Gil} and Lee, {Seung Hwan}",
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Factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma : A retrospective study. / Kim, Myoung Jun; Lee, Jae Gil; Lee, Seung Hwan.

In: BMC Surgery, Vol. 18, No. 1, 438, 16.11.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma

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AU - Kim, Myoung Jun

AU - Lee, Jae Gil

AU - Lee, Seung Hwan

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N2 - Background: Blunt pelvic injuries are often associated with pelvic fractures and injuries to the rectum and genitourinary tract. Pelvic fractures can lead to life-threatening hemorrhage, which is a common cause of morbidity and mortality in trauma. Thus, early identification of patients with pelvic fractures at risk severe bleeding requiring urgent hemorrhage control is crucial. This study aimed to investigate early factors predicting the need for hemorrhage control in blunt pelvic trauma. Methods: The medical records of 1760 trauma patients were reviewed retrospectively between January 2013 and June 2018. We enrolled 187 patients with pelvic fracture due to blunt trauma who were older than 15 years. The pelvic fracture pattern was classified according to the Orthopedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen (OTA/AO) classification. A multivariate logistic regression model was used to determine independent predictors of the need for pelvic hemorrhage control intervention. Results: The most common pelvic fracture pattern was type A (54.5%), followed by types B (36.9%) and C (8.6%). Of 187 patients, 48 (25.7%) required pelvic hemorrhage control intervention. Hemorrhage control interventions were most frequently performed in patients with type B fractures (54.2%). Multivariate logistic regression analysis revealed that type B (odds ratio [OR] = 4.024, 95% confidence interval [CI] = 1.666-9.720, p = 0.002) and C (OR = 7.077, 95% CI = 1.781-28.129, p = 0.005) fracture patterns, decreased body temperature (OR = 2.275, 95% CI = 0.134-0.567, p < 0.001), and elevated serum lactate level (OR = 1.234, 95% CI = 1.061-1.435, p = 0.006) were factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma. Conclusion: Patients with type B and C fracture patterns on the OTA/AO classification, hypothermia, or an elevated serum lactate level are at risk for bleeding and require pelvic hemorrhage control intervention.

AB - Background: Blunt pelvic injuries are often associated with pelvic fractures and injuries to the rectum and genitourinary tract. Pelvic fractures can lead to life-threatening hemorrhage, which is a common cause of morbidity and mortality in trauma. Thus, early identification of patients with pelvic fractures at risk severe bleeding requiring urgent hemorrhage control is crucial. This study aimed to investigate early factors predicting the need for hemorrhage control in blunt pelvic trauma. Methods: The medical records of 1760 trauma patients were reviewed retrospectively between January 2013 and June 2018. We enrolled 187 patients with pelvic fracture due to blunt trauma who were older than 15 years. The pelvic fracture pattern was classified according to the Orthopedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen (OTA/AO) classification. A multivariate logistic regression model was used to determine independent predictors of the need for pelvic hemorrhage control intervention. Results: The most common pelvic fracture pattern was type A (54.5%), followed by types B (36.9%) and C (8.6%). Of 187 patients, 48 (25.7%) required pelvic hemorrhage control intervention. Hemorrhage control interventions were most frequently performed in patients with type B fractures (54.2%). Multivariate logistic regression analysis revealed that type B (odds ratio [OR] = 4.024, 95% confidence interval [CI] = 1.666-9.720, p = 0.002) and C (OR = 7.077, 95% CI = 1.781-28.129, p = 0.005) fracture patterns, decreased body temperature (OR = 2.275, 95% CI = 0.134-0.567, p < 0.001), and elevated serum lactate level (OR = 1.234, 95% CI = 1.061-1.435, p = 0.006) were factors predicting the need for hemorrhage control intervention in patients with blunt pelvic trauma. Conclusion: Patients with type B and C fracture patterns on the OTA/AO classification, hypothermia, or an elevated serum lactate level are at risk for bleeding and require pelvic hemorrhage control intervention.

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