Cordts Filho Roberto de Moraes, Parreira José Gustavo, Perlingeiro Jaqueline A Giannini, Soldá Silvia C, Campos Tércio de, Assef José Cesar
Department of Surgery, Faculdade de Ciência Médicas da Santa Casa de São Paulo, Emergency Service, Santa Casa de Misericordia de Sao Paulo.
Rev Col Bras Cir. 2011 Sep-Oct;38(5):310-6.
To assess whether the presence of a pelvic fracture is associated with greater severity and worse prognosis in victims of blunt trauma.
A retrospective analysis of protocols and records of victims of blunt trauma admitted from June 2008 to March 2009 was separated into two groups: those with pelvic fracture (Group I) and those without it (Group II). Data were collected from pre-hospital admission rates of trauma, laboratory tests, diagnosed lesions, treatment and outcome. We used the Student t test, Fisher's exact test and chi-square test for statistical analysis, considering p <0.05 as significant.
During the study period, 2019 individuals had multiple trauma protocols completed, of which 43 (2.1%) had pelvic fractures. Patients in Group I had significantly lower average blood pressure, higher mean heart rate, lower mean Glasgow Coma Scale, the highest average AIS in the segments head, chest, abdomen and extremities, as well as higher mean ISS and lower mean TRISS and RTS on admission. Group I more frequently presented with traumatic subarachnoid hemorrhage (7% vs. 1.6%), spinal cord injury (9% vs. 1%), thoracic and abdominal injuries, as well as need for laparotomy (21% vs. 1 %), chest drainage (32% vs. 2%) and damage control (9% vs. 0%). Complications were more frequent in group I: ARDS (9% vs. 0%), persistent shock (30% vs. 1%), coagulopathy (23% vs. 1%), acute renal failure (21% vs. 0%) and death (28% vs. 2%).
The presence of a pelvic fracture is a marker of greater severity and worse prognosis in victims of blunt trauma.
评估骨盆骨折的存在是否与钝性创伤受害者更严重的病情和更差的预后相关。
对2008年6月至2009年3月收治的钝性创伤受害者的诊疗方案和记录进行回顾性分析，将患者分为两组：有骨盆骨折的患者（第一组）和无骨盆骨折的患者（第二组）。收集院前创伤发生率、实验室检查、确诊损伤、治疗及预后等数据。采用Student t检验、Fisher精确检验和卡方检验进行统计学分析，以p<0.05为有统计学意义。
在研究期间，2019例患者完成了多发伤诊疗方案，其中43例（2.1%）有骨盆骨折。第一组患者入院时平均血压显著较低、平均心率较高、平均格拉斯哥昏迷评分较低、头部、胸部、腹部和四肢部位的平均简明损伤定级最高，以及平均损伤严重度评分较高、平均创伤严重度积分和创伤评分较低。第一组更频繁出现创伤性蛛网膜下腔出血（7%对1.6%）、脊髓损伤（9%对1%）、胸腹部损伤，以及需要剖腹手术（21%对1%）、胸腔引流（32%对2%）和损害控制（9%对0%）。第一组并发症更常见：急性呼吸窘迫综合征（9%对0%）、持续性休克（30%对1%）、凝血功能障碍（23%对1%）、急性肾衰竭（21%对0%）和死亡（28%对2%）。
骨盆骨折的存在是钝性创伤受害者病情更严重和预后更差的一个标志。
