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Abstract：
This study aimed to investigate the clinical features, current management strategies, and outcomes of open pelvic fracture patients.
We performed a retrospective review of data on patients with blunt trauma and open pelvic fractures admitted to our trauma center over a 5-year period (January 2013 to December 2017). Demographic as well as clinical data including injury mechanism, injury severity score (ISS), fracture classifications, transfusion requirements, interventions, length of hospital and intensive care unit (ICU) stay, and prognosis were investigated. Univariate analysis and binary logistic regression were used to identify the risk variables of death. Finally, a brief literature review was performed to understand the current capacity of treatment and prognosis of this type of injury.
Forty-six patients (36 male and 10 female) were included in this study, mean age 43.2 ± 14.2 years. The overall mortality rate was 17.4%; 43.5% of the patients were hypotensive (systolic blood pressure (SBP) <90 mmHg) on arrival. The average ISS was 31.7 ± 6.7, and the average packed red blood cell (PRBC) transfusion during the first 24 h was 9.6 ± 7.4 units. Five patients (10.9%) underwent transcatheter arterial embolization in the early stage of management. The average hospital and ICU length of stay were 53.0 ± 37.6 days and 14.3 ± 15.3 days, respectively. Statistically significant differences were found in ISS, PRBC units received with the first 24 h, SBP, lactate and base excess on admission, and mechanism of injury when comparing between the death and the survival groups (p < 0.05). ISS and lactate on admission were found to be the independent risk factors for mortality.
The mortality rate of open pelvic fractures remains high. ISS and lactate on admission were the independent risk factors for mortality. Optimization of the trauma care algorithms for early identification and treatment of this injury could be the key to decreasing mortality.
We performed a retrospective review of data on patients with blunt trauma and open pelvic fractures admitted to our trauma center over a 5-year period (January 2013 to December 2017). Demographic as well as clinical data including injury mechanism, injury severity score (ISS), fracture classifications, transfusion requirements, interventions, length of hospital and intensive care unit (ICU) stay, and prognosis were investigated. Univariate analysis and binary logistic regression were used to identify the risk variables of death. Finally, a brief literature review was performed to understand the current capacity of treatment and prognosis of this type of injury.
Forty-six patients (36 male and 10 female) were included in this study, mean age 43.2 ± 14.2 years. The overall mortality rate was 17.4%; 43.5% of the patients were hypotensive (systolic blood pressure (SBP) <90 mmHg) on arrival. The average ISS was 31.7 ± 6.7, and the average packed red blood cell (PRBC) transfusion during the first 24 h was 9.6 ± 7.4 units. Five patients (10.9%) underwent transcatheter arterial embolization in the early stage of management. The average hospital and ICU length of stay were 53.0 ± 37.6 days and 14.3 ± 15.3 days, respectively. Statistically significant differences were found in ISS, PRBC units received with the first 24 h, SBP, lactate and base excess on admission, and mechanism of injury when comparing between the death and the survival groups (p < 0.05). ISS and lactate on admission were found to be the independent risk factors for mortality.
The mortality rate of open pelvic fractures remains high. ISS and lactate on admission were the independent risk factors for mortality. Optimization of the trauma care algorithms for early identification and treatment of this injury could be the key to decreasing mortality.
摘要：
本研究旨在探讨其临床特征,当前的管理策略，开放性骨盆骨折患者的预后。
我们对创伤中心收治的5年（2013年1月至2017年12月）闭合性创伤和开放性骨盆骨折患者的数据进行了回顾性分析。人口统计以及包括损伤机制在内的临床数据，损伤严重程度评分（ISS），骨折分类,输血要求，干预措施，住院和重症监护病房(ICU)住院时间，并对预后进行了调查。使用单因素分析和二元逻辑回归来确定死亡风险变量。最后,我们进行了简短的文献综述,以了解此类损伤目前的治疗能力和预后.
这项研究纳入了46名患者（36名男性和10名女性）。平均年龄43.2±14.2岁。总死亡率为17.4％；43.5％的患者在到达时出现低血压（收缩压（SBP）<90mmHg）。平均ISS为31.7±6.7，前24小时平均充血红细胞（PRBC）为9.6±7.4单位。5例（10.9％）在治疗的早期接受了经导管动脉栓塞。平均住院时间和ICU住院时间分别为53.0±37.6天和14.3±15.3天,分别。在国际空间站发现了统计学上的显著差异，前24小时收到的PRBC单位，SBP,入院时乳酸和基数过量，死亡组和存活组比较，损伤机制（p<0.05）。发现ISS和入院时的乳酸是死亡的独立危险因素。
开放性骨盆骨折的死亡率仍然很高。ISS和入院时乳酸是死亡的独立危险因素。优化创伤护理算法以早期识别和治疗这种损伤可能是降低死亡率的关键。
我们对创伤中心收治的5年（2013年1月至2017年12月）闭合性创伤和开放性骨盆骨折患者的数据进行了回顾性分析。人口统计以及包括损伤机制在内的临床数据，损伤严重程度评分（ISS），骨折分类,输血要求，干预措施，住院和重症监护病房(ICU)住院时间，并对预后进行了调查。使用单因素分析和二元逻辑回归来确定死亡风险变量。最后,我们进行了简短的文献综述,以了解此类损伤目前的治疗能力和预后.
这项研究纳入了46名患者（36名男性和10名女性）。平均年龄43.2±14.2岁。总死亡率为17.4％；43.5％的患者在到达时出现低血压（收缩压（SBP）<90mmHg）。平均ISS为31.7±6.7，前24小时平均充血红细胞（PRBC）为9.6±7.4单位。5例（10.9％）在治疗的早期接受了经导管动脉栓塞。平均住院时间和ICU住院时间分别为53.0±37.6天和14.3±15.3天,分别。在国际空间站发现了统计学上的显著差异，前24小时收到的PRBC单位，SBP,入院时乳酸和基数过量，死亡组和存活组比较，损伤机制（p<0.05）。发现ISS和入院时的乳酸是死亡的独立危险因素。
开放性骨盆骨折的死亡率仍然很高。ISS和入院时乳酸是死亡的独立危险因素。优化创伤护理算法以早期识别和治疗这种损伤可能是降低死亡率的关键。
