Auditing 655 fatalities with pelvic fractures by autopsy as a basis to evaluate trauma care

Papadopoulos, IN; Kanakaris, N; Bonovas, S; Triantafillidis, A; Garnavos, C; Voros, D; Leukidis, C

dc.contributor.author	Papadopoulos, IN	en
dc.contributor.author	Kanakaris, N	en
dc.contributor.author	Bonovas, S	en
dc.contributor.author	Triantafillidis, A	en
dc.contributor.author	Garnavos, C	en
dc.contributor.author	Voros, D	en
dc.contributor.author	Leukidis, C	en
dc.date.accessioned	2014-03-01T01:23:39Z
dc.date.available	2014-03-01T01:23:39Z
dc.date.issued	2006	en
dc.identifier.issn	1072-7515	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/17068
dc.subject.classification	Surgery	en
dc.subject.other	INJURY SEVERITY	en
dc.subject.other	MORTALITY	en
dc.subject.other	ACCIDENTS	en
dc.subject.other	EPIDEMIOLOGY	en
dc.subject.other	HEMORRHAGE	en
dc.subject.other	SCORE	en
dc.title	Auditing 655 fatalities with pelvic fractures by autopsy as a basis to evaluate trauma care	en
heal.type	journalArticle	en
heal.identifier.primary	10.1016/j.jamcollsurg.2006.03.017	en
heal.identifier.secondary	http://dx.doi.org/10.1016/j.jamcollsurg.2006.03.017	en
heal.language	English	en
heal.publicationDate	2006	en
heal.abstract	BACKGROUND: To determine the role of pelvic fractures in auditing mortality resulting from trauma. STUDY DESIGN: This retrospective case-control study based on autopsy-evaluated circumstances of the deaths of patients with pelvic fractures. RESULTS: Of 2,583 patients injured in motor-vehicle collisions, 655 (25.4%) constituted the pelvic fracture (PFx) group, and 1,928 (74.6%) constituted the control group. One-third of the PFx group's fatalities had an Injury Severity Score (ISS) of 75 and were not preventable. The PFx group had a substantially higher median ISS than the control group (50 versus 34; p < 0.0001). Four hundred fifty-four patients (69.3%) in the PFx group with ISS 16 to 74 had substantially higher rates of associated injuries. Nearly half of the PFx group patients with ISS 74 had a potential cause of major hemorrhage other than pelvic fracture. Twenty-three (3.5%) deaths were directly attributable to pelvic fractures. Postinjury median survival time was 55 minutes for the PFx group and 100 minutes for the control group (p < 0.0001). The time limit for management of the patients with pelvic fractures was short, as 527 (81.5%) died in the first 6 hours. It was evident that the more severe the injuries were, the sooner the deaths occurred. Of 151 subjects who left the emergency department alive, 61.6% were subjected to operation and 48.3% to abdominal operation. CONCLUSIONS: Pelvic fracture is an indicator of severe. multiple trauma, but a small proportion of deaths are directly attributable to pelvic fracture. A method based on autopsy audited patients with pelvic fractures as a paradigm of injury revealed that pelvic fracture is an important injury to consider in auditing trauma care and indicated several issues that should be considered to reduce mortality.	en
heal.publisher	ELSEVIER SCIENCE INC	en
heal.journalName	JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS	en
dc.identifier.doi	10.1016/j.jamcollsurg.2006.03.017	en
dc.identifier.isi	ISI:000238720700005	en
dc.identifier.volume	203	en
dc.identifier.issue	1	en
dc.identifier.spage	30	en
dc.identifier.epage	43	en