%0 Journal Article
%T Identification and Management of Pelvic Fractures in Prehospital and Emergency Department Settings.
%A Coulombe P
%A Malo C
%A Robitaille-Fortin M
%A Nadeau A
%A Émond M
%A Moore L
%A Blanchard PG
%A Benhamed A
%A Mercier E
%J J Surg Res
%V 300
%N 0
%D 2024 Jun 5
%M 38843724
%F 2.417
%R 10.1016/j.jss.2024.05.006
%X <B>BACKGROUND: </B>This study aims to describe the characteristics of patients with a pelvic fracture treated at a level 1 trauma center, the proportion of prehospital undertriage and the use of pelvic circumferential compression device (PCCD).<BR><B>METHODS: </B>This is a retrospective cohort study. Prehospital and inhospital medical records of adults (≥16 y old) with a pelvic fracture who were treated at Hopital de l'Enfant-Jesus-CHU de Québec (Quebec City, Canada), a university-affiliated level 1 trauma center, between September 01, 2017 and September 01, 2021 were reviewed. Isolated hip or pubic ramus fracture were excluded. Data are presented using proportions and means with standard deviations.<BR><B>RESULTS: </B>A total of 228 patients were included (males: 62.3%; mean age: 54.6 [standard deviation 21.1]). Motor vehicle collision (47.4%) was the main mechanism of injury followed by high-level fall (21.5%). Approximately a third (34.2%) needed at least one blood transfusion. Compared to those admitted directly, transferred patients were more likely to be male (73.0% versus 51.3%, P < 0.001) and to have a surgical procedure performed at the trauma center (71.3% versus 46.9%, P < 0.001). The proportion of prehospital undertriage was 22.6%. Overall, 17.1% had an open-book fracture and would have potentially benefited from a prehospital PCCD. Forty-six transferred patients had a PCCD applied at the referral hospital of which 26.1% needed adjustment.<BR><B>CONCLUSIONS: </B>Pelvic fractures are challenging to identify in the prehospital environment and are associated with a high undertriage of 22.6%. Reducing undertriage and optimizing the use of PCCD are key opportunities to improve care of patients with a pelvic fracture.