Research on relation of mortality and hemodynamics in patients with an acute pelvic ring fracture

ObjectiveTo study the treatment pathway of hemodynamic unstable patients with a pelvic ring fracture and analyze the causes of death in this group.MethodsRetrospectively, all data of hemodynamic unstable patients with a pelvic ring fracture in the period 1 January 2003 till 1 June 2010 were analyzed. For all patients the treatment protocol was assessed and compared with our protocol.ResultsThe data of 268 patients were analyzed. Among them, 89 cases presented as hemodynamic unstable. A total of 22/89 patients died (25%). Seven patients died because of an isolated circulatory problem, 1 of an isolated neurotrauma. Fourteen patients died because of a combination of vital injuries, in which 11 sustained extensive hemorrhage. Hemorrhage contributed to mortality in 18/22 patients (82%). In 12 of the 22 patients who died, the treatment protocol was not followed. This was significantly higher than in the group survivors (P < 0.01).ConclusionsMortality in patients with a pelvic fracture is most often caused by hemorrhage or sequelae from hemorrhage. A standardized treatment protocol reduces mortality.