Abstract：
OBJECTIVE: To analyze the use of packed red blood cells (PRBCs) for patients with pelvic fracture and evaluate factors associated with PRBC transfusion for patients with pelvic fracture.
METHODS: This retrospective cohort study collected 551 patients with pelvic fractures from six hospitals between September 1, 2012, and June 31, 2019. The age span of patients varied from 10 to 95 years old, and they were classified into two groups based on high-energy pelvic fractures (HE-PFs) or low-energy pelvic fractures (LE-PFs). The study\'s outcome was the use of PRBCs, fresh frozen plasma (FFP), and albumin. Demographic data, characteristics, laboratory tests, clinical treatment details, and clinical outcomes were compared between the two groups. Factors that were statistically associated with perioperative PRBCs in univariate analyses were included to conduct an optimal scale regression to determine the independent factors for perioperative PRBCs.
RESULTS: A total of 551 patients were screened from six hospitals, and after inclusion and exclusion, 319 were finally included and finished the follow-up from admission to discharge, while four patients died during hospitalization. Three hundred and nineteen patients were classified into two groups by their injury mechanisms. A total of 230/319 (72.1%) patients were classified into the HE-PF group, and 89/319 (27.8%) patients were classified into the LE-PF group. Patients in the HE-PF group were transfused with 4.5 (3-8) units of PRBCs, 300 (0-600) ml of FFP, and 0 (0-30) g of albumin, while patients in the LE-PF group were transfused with 3.5 (2-4.5) units of PRBCs, 0 (0-295) ml of FFP, and 0 (0-0) g of albumin (all P < 0.001). There were higher proportions of male patients and patients under 65 in the HE-PF group (all P < 0.001). HE-PF group patients were more severely injured and likely to take external fixation. The optimal scale regression revealed four significant factors associated with perioperative transfused PRBCs, which were patients on admission with hemorrhagic shock (importance = 0.283, P = 0.004), followed by fracture types identified by Tile classification (importance = 0.156, P < 0.001), hemoglobin levels below 70 g/L on admission (importance = 0.283, P = 0.004), followed by fracture types identified by Tile classification (importance = 0.156, P < 0.001), hemoglobin levels below 70 g/L on admission (importance = 0.148, P = 0.039), and methods of pelvic fixation (importance = 0.008, P = 0.026), ranked by the importance.
CONCLUSIONS: Patients with HE-PFs had increased transfusions of PRBCs, FFP, and albumin, and hemorrhagic shock on admission, Tile classification, Hb levels, and stabilization methods were found to be associated with perioperative PRBCs.
METHODS: This retrospective cohort study collected 551 patients with pelvic fractures from six hospitals between September 1, 2012, and June 31, 2019. The age span of patients varied from 10 to 95 years old, and they were classified into two groups based on high-energy pelvic fractures (HE-PFs) or low-energy pelvic fractures (LE-PFs). The study\'s outcome was the use of PRBCs, fresh frozen plasma (FFP), and albumin. Demographic data, characteristics, laboratory tests, clinical treatment details, and clinical outcomes were compared between the two groups. Factors that were statistically associated with perioperative PRBCs in univariate analyses were included to conduct an optimal scale regression to determine the independent factors for perioperative PRBCs.
RESULTS: A total of 551 patients were screened from six hospitals, and after inclusion and exclusion, 319 were finally included and finished the follow-up from admission to discharge, while four patients died during hospitalization. Three hundred and nineteen patients were classified into two groups by their injury mechanisms. A total of 230/319 (72.1%) patients were classified into the HE-PF group, and 89/319 (27.8%) patients were classified into the LE-PF group. Patients in the HE-PF group were transfused with 4.5 (3-8) units of PRBCs, 300 (0-600) ml of FFP, and 0 (0-30) g of albumin, while patients in the LE-PF group were transfused with 3.5 (2-4.5) units of PRBCs, 0 (0-295) ml of FFP, and 0 (0-0) g of albumin (all P < 0.001). There were higher proportions of male patients and patients under 65 in the HE-PF group (all P < 0.001). HE-PF group patients were more severely injured and likely to take external fixation. The optimal scale regression revealed four significant factors associated with perioperative transfused PRBCs, which were patients on admission with hemorrhagic shock (importance = 0.283, P = 0.004), followed by fracture types identified by Tile classification (importance = 0.156, P < 0.001), hemoglobin levels below 70 g/L on admission (importance = 0.283, P = 0.004), followed by fracture types identified by Tile classification (importance = 0.156, P < 0.001), hemoglobin levels below 70 g/L on admission (importance = 0.148, P = 0.039), and methods of pelvic fixation (importance = 0.008, P = 0.026), ranked by the importance.
CONCLUSIONS: Patients with HE-PFs had increased transfusions of PRBCs, FFP, and albumin, and hemorrhagic shock on admission, Tile classification, Hb levels, and stabilization methods were found to be associated with perioperative PRBCs.
摘要：
目的：分析骨盆骨折患者红细胞压积（PRBC）的使用情况，并评估骨盆骨折患者PRBC输注的相关因素。
方法：这项回顾性队列研究收集了2012年9月1日至2019年6月31日期间来自六家医院的551例骨盆骨折患者。患者的年龄跨度从10岁到95岁不等，根据高能量骨盆骨折(HE-PFs)或低能量骨盆骨折(LE-PFs)分为两组.这项研究的结果是使用PRBC，新鲜冷冻血浆（FFP），和白蛋白。人口统计数据,特点,实验室测试,临床治疗细节，比较两组患者的临床结局。纳入单因素分析中与围手术期PRBC相关的因素进行最佳量表回归，以确定围手术期PRBC的独立因素。
结果：共筛查了来自六家医院的551名患者，在包容和排斥之后，最终纳入319名，并完成了从入院到出院的随访，而四名患者在住院期间死亡。根据损伤机制将119例患者分为两组。共有230/319（72.1%）患者被归入HE-PF组，89/319（27.8%）患者被分为LE-PF组。HE-PF组患者输注4.5（3-8）单位的PRBC，300(0-600)mlFFP,和0（0-30）g白蛋白，而LE-PF组患者输注3.5（2-4.5）单位的PRBC，0（0-295）ml的FFP，和0（0-0）g白蛋白（均P<0.001）。HE-PF组男性和65岁以下患者比例较高(P均<0.001)。HE-PF组患者受伤更严重，可能采取外固定支架。最佳量表回归显示与围手术期输注PRBC相关的四个重要因素，入院时失血性休克患者（重要性=0.283，P=0.004），其次是通过Tile分类确定的骨折类型（重要性=0.156，P<0.001），入院时血红蛋白水平低于70g/L（重要性=0.283，P=0.004），其次是通过Tile分类确定的骨折类型（重要性=0.156，P<0.001），入院时血红蛋白水平低于70g/L（重要性=0.148，P=0.039），和骨盆固定方法（重要性=0.008，P=0.026），按重要性排序。
结论：HE-PFs患者的PRBC输血增加，FFP,和白蛋白,入院时失血性休克，瓷砖分类,Hb水平,发现稳定方法与围手术期PRBC相关。
方法：这项回顾性队列研究收集了2012年9月1日至2019年6月31日期间来自六家医院的551例骨盆骨折患者。患者的年龄跨度从10岁到95岁不等，根据高能量骨盆骨折(HE-PFs)或低能量骨盆骨折(LE-PFs)分为两组.这项研究的结果是使用PRBC，新鲜冷冻血浆（FFP），和白蛋白。人口统计数据,特点,实验室测试,临床治疗细节，比较两组患者的临床结局。纳入单因素分析中与围手术期PRBC相关的因素进行最佳量表回归，以确定围手术期PRBC的独立因素。
结果：共筛查了来自六家医院的551名患者，在包容和排斥之后，最终纳入319名，并完成了从入院到出院的随访，而四名患者在住院期间死亡。根据损伤机制将119例患者分为两组。共有230/319（72.1%）患者被归入HE-PF组，89/319（27.8%）患者被分为LE-PF组。HE-PF组患者输注4.5（3-8）单位的PRBC，300(0-600)mlFFP,和0（0-30）g白蛋白，而LE-PF组患者输注3.5（2-4.5）单位的PRBC，0（0-295）ml的FFP，和0（0-0）g白蛋白（均P<0.001）。HE-PF组男性和65岁以下患者比例较高(P均<0.001)。HE-PF组患者受伤更严重，可能采取外固定支架。最佳量表回归显示与围手术期输注PRBC相关的四个重要因素，入院时失血性休克患者（重要性=0.283，P=0.004），其次是通过Tile分类确定的骨折类型（重要性=0.156，P<0.001），入院时血红蛋白水平低于70g/L（重要性=0.283，P=0.004），其次是通过Tile分类确定的骨折类型（重要性=0.156，P<0.001），入院时血红蛋白水平低于70g/L（重要性=0.148，P=0.039），和骨盆固定方法（重要性=0.008，P=0.026），按重要性排序。
结论：HE-PFs患者的PRBC输血增加，FFP,和白蛋白,入院时失血性休克，瓷砖分类,Hb水平,发现稳定方法与围手术期PRBC相关。
