Bible Jesse E, Kadakia Rishin J, Wegner Adam, Richards Justin E, Mir Hassan R
Department of Orthopaedic Surgery, Vanderbilt Orthopaedic Institute, Medical Center East, South Tower, Ste 4200, 1215 21st Ave S, Nashville, TN 37232-8774, USA.
Orthopedics. 2013 Jun;36(6):760-4. doi: 10.3928/01477447-20130523-21.
Previous 1-year mortality studies of pelvic fractures in elderly patients have focused on pubic rami fractures, in elderly patients with multiple injuries, or both. Baseline information on the 1-year mortality of isolated pelvic fractures in elderly patients is unavailable. The purpose of this study was to evaluate the 1-year mortality of elderly patients (aged 60 years or older) after isolated pelvic fractures with posterior ring involvement (Orthopaedic Trauma Association type 61-B and C). All patients aged 60 years or older treated for pelvic injuries at a single Level I trauma center over a 12-year period were retrospectively reviewed (N=1223). Exclusion criteria were associated injuries to other body systems (Abbreviated Injury Scale greater than 2), ballistic injuries, long bone fractures, concurrent acetabular fractures, and type 61-A fractures or isolated pubic rami fractures without posterior involvement. Mortality data were obtained from the Social Security Death Index. Seventy patients met the inclusion criteria. Patients treated nonoperatively were significantly older compared with those treated operatively. However, the Charlson Comorbidity Index did not significantly differ between treatment groups. A significantly higher percentage of type-B fractures (83.0%) were treated nonoperatively compared with type-C fractures, which were treated operatively 88.2% of the time. Mortality rates at 3 and 6 months and 1 year postoperatively were 7.1%, 11.4%, and 12.9%, respectively. These results suggest that the 1-year mortality rates of isolated pelvic fractures in elderly patients are lower than those reported previously for hip fractures and pelvic fractures with concurrent injuries. Although age was identified as a significant variable differing between patients treated operatively vs nonoperatively, comorbidities were not.
既往关于老年患者骨盆骨折的1年死亡率研究主要集中在耻骨支骨折、合并多处损伤的老年患者或两者兼有。目前尚无关于老年患者孤立性骨盆骨折1年死亡率的基线信息。本研究的目的是评估老年患者（60岁及以上）孤立性骨盆骨折伴后环损伤（骨科创伤协会61 - B型和C型）后的1年死亡率。对一家一级创伤中心在12年期间治疗的所有60岁及以上骨盆损伤患者（N = 1223）进行回顾性研究。排除标准为其他身体系统的相关损伤（简明损伤定级大于2）、弹道伤、长骨骨折、同时存在的髋臼骨折以及61 - A型骨折或无后环累及的孤立耻骨支骨折。死亡率数据来自社会保障死亡指数。70例患者符合纳入标准。非手术治疗的患者比手术治疗的患者年龄显著更大。然而，治疗组之间的Charlson合并症指数无显著差异。与C型骨折相比，B型骨折非手术治疗的比例显著更高（83.0%），C型骨折手术治疗的时间为88.2%。术后3个月、6个月和1年的死亡率分别为7.1%、11.4%和12.9%。这些结果表明，老年患者孤立性骨盆骨折的1年死亡率低于先前报道的髋部骨折和合并损伤的骨盆骨折。虽然年龄被确定为手术治疗与非手术治疗患者之间的显著差异变量，但合并症并非如此。
