International journal of emergency medicine · 2025
Clinical characteristics and mortality risk factors in polytrauma patients with pelvic fractures: a retrospective study based on an integrated multidisciplinary treatment approach.
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Ding Haixiang, Wang Wenwen, Sun Wei, Liu Li, Huang Ming, Han Dong, Lu Yaozhong, Zhou Jianhong, Pan Jingshi
Аннотация
PURPOSE: Pelvic fractures in polytrauma patients represent complex injuries associated with substantial mortality rates. This study examined clinical characteristics, multidisciplinary collaborative management approaches, and mortality risk factors in these patients to establish clinical references for optimizing comprehensive treatment strategies.
METHODS: We retrospectively analyzed clinical data from 32 polytrauma patients with pelvic fractures managed under an integrated multidisciplinary treatment protocol in our trauma center's Emergency Intensive Care Unit (EICU). This protocol incorporated expedited prehospital transport, trauma team activation before patient arrival, "resuscitation in the operating room" strategy, and collaborative intervention from emergency surgery, trauma surgery, interventional radiology, and EICU teams. We collected patient demographics, injury characteristics, therapeutic interventions, and outcome data. Univariate and correlation analyses were employed to identify mortality risk factors.
RESULTS: The study cohort (n = 32) had a mean age of 51.2 ± 18.3 years, with female predominance (62.5%). Motor vehicle accidents constituted the primary injury mechanism (75.0%). Thoracic injuries were the most prevalent concomitant injuries (87.5%). Under the multidisciplinary collaborative approach, 37.5% of patients underwent early external pelvic fixation, and 6.3% received transcatheter arterial embolization (TAE). Surgical interventions significantly reduced pain scores (p < 0.001). The overall mortality rate was 9.4% (3/32). Correlation analysis demonstrated a negative association between mortality and Glasgow Coma Scale (GCS) scores (-0.710) and a positive correlation with Injury Severity Score (ISS) (0.547).
CONCLUSION: Polytrauma with pelvic fractures carries substantial mortality risk. Initial GCS scores and ISS were identified as independent mortality risk factors. Optimization of integrated multidisciplinary treatment protocols with early identification of mortality risk factors and timely interventions appears essential for reducing mortality in this complex patient population.
METHODS: We retrospectively analyzed clinical data from 32 polytrauma patients with pelvic fractures managed under an integrated multidisciplinary treatment protocol in our trauma center's Emergency Intensive Care Unit (EICU). This protocol incorporated expedited prehospital transport, trauma team activation before patient arrival, "resuscitation in the operating room" strategy, and collaborative intervention from emergency surgery, trauma surgery, interventional radiology, and EICU teams. We collected patient demographics, injury characteristics, therapeutic interventions, and outcome data. Univariate and correlation analyses were employed to identify mortality risk factors.
RESULTS: The study cohort (n = 32) had a mean age of 51.2 ± 18.3 years, with female predominance (62.5%). Motor vehicle accidents constituted the primary injury mechanism (75.0%). Thoracic injuries were the most prevalent concomitant injuries (87.5%). Under the multidisciplinary collaborative approach, 37.5% of patients underwent early external pelvic fixation, and 6.3% received transcatheter arterial embolization (TAE). Surgical interventions significantly reduced pain scores (p < 0.001). The overall mortality rate was 9.4% (3/32). Correlation analysis demonstrated a negative association between mortality and Glasgow Coma Scale (GCS) scores (-0.710) and a positive correlation with Injury Severity Score (ISS) (0.547).
CONCLUSION: Polytrauma with pelvic fractures carries substantial mortality risk. Initial GCS scores and ISS were identified as independent mortality risk factors. Optimization of integrated multidisciplinary treatment protocols with early identification of mortality risk factors and timely interventions appears essential for reducing mortality in this complex patient population.