Abstrait

Incidence of pelvic trauma and relative risk factors for mortality: a population based study in Iran

Keykhosro Mardanpour*, Nyoush Mardanpour, Mahtab Rahbar & Elham Zarei

Background: Pelvic trauma (PT) constitutes one of the most devastating injuries in musculo-skeletal trauma. Early treatment and focusing on predisposing factors predicting mortality are essential. We tried to investigate distribution of demographics pelvic trauma, its various causes ,types, fracture sites, associated injuries, and risk factors for mortality on a population basis. Methods: Of 68102 patients with pelvic trauma, 68000 patients were included for the final analysis. Information about all patients with any ICD-9-CM coded as pelvic injury was retrieved as part of a claims dataset. Based on Revised Trauma Score (RTS), Injury Severity Score (ISS) and Age, Trauma - Injury Severity Score (TRISS) was recorded as predictors of survival rate. Results: The incidence rate PT is 13.9/100,000 person years (9.9/100,000 for male, 4/100,000 for female). The highest incidence rate PT was in the age 46-60 years group. The highest mortality rate PT happened in the age group more than75 years. The mean length of stay was 8.5 days (females, 7.4 ± 1.3 days; males, 9.2 ± 3.5 days; p<0.02). The trauma indices showed that PT had significantly higher mean AIS in the abdomen> chest> head> >multiple pelvic fracture as well as higher average ISS. They also showed lower mean RTS and lower mean probability of survival (TRISS). The most common causes of mortality of PT were massive hemorrhage (42%) and the second was multiple pelvic fractures. (39%) Also, demographic characters such as male gender (P<0.02), age >75years (P<0.03), smoking (P<0.05), automobile accident (P<0.05) set the patient at risk of mortality. Conclusion: The overall incidence rate of pelvic trauma was higher in the older age male and in low socioeconomic level. Also, massive bleeding, multiple pelvic fractures, coagulopathy problems and injury-related abdominal injuries were stronger positive predicting factors for mortality.