From the Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL (Hamilton, Harnett, Stone, Furey).
Can J Surg. 2019 Aug 1;62(4):270-274. doi: 10.1503/cjs.011518.
Pelvic ramus fractures in older patients are associated with substantial morbidity and mortality. There is a paucity of literature on fractures of the pelvis in this age group. The purpose of this study was to report mortality rates following such injuries. In addition, we aimed to describe and quantify the important resultant morbidity in this vulnerable population.
We performed a retrospective chart review of all low-energy pelvic ramus fractures in patients more than age 60 years that occurred between January 2000 and December 2005. Data on survival, hospital length of stay, ambulatory status and place of residence were recorded. For comparison, we calculated the mortality rate for a surrogate age- and sex-matched group using Statistics Canada survival data for use as an uninjured control group.
We identified 43 patients (32 women [74%]; mean age 79.4 yr) with isolated low-energy pelvic ramus fractures over the study period. The 1- and 5-year mortality rates were 16.3% (95% confidence interval [CI] 7.8%–30.3%) and 58.1% (95% CI 43.3%–71.6%), respectively, both significantly higher than the point estimates for the control group (6.6% and 31.3%, respectively). Following injury, 14/39 patients (36%) permanently required increased ambulatory aids, and 8 (20%) required a permanent increase in everyday level of care.
The results suggest that there may be increased mortality and morbidity following low-energy pattern pelvic ramus fractures in an older population compared to age- and sex-matched uninjured control subjects.
老年患者的骨盆支骨折与较高的发病率和死亡率相关。关于该年龄段人群的骨盆骨折，文献报道较少。本研究旨在报告此类损伤的死亡率。此外，我们旨在描述和量化这一脆弱人群的重要相关发病率。
我们对 2000 年 1 月至 2005 年 12 月期间发生的所有 60 岁以上低能量骨盆支骨折患者进行了回顾性图表审查。记录了生存率、住院时间、活动能力和居住地点的数据。为了进行比较，我们使用加拿大统计局的生存数据计算了一个替代的年龄和性别匹配组的死亡率，作为未受伤的对照组。
我们在研究期间确定了 43 例（32 名女性[74%]；平均年龄 79.4 岁）孤立性低能量骨盆支骨折患者。1 年和 5 年的死亡率分别为 16.3%（95%置信区间[CI]7.8%–30.3%）和 58.1%（95% CI 43.3%–71.6%），均显著高于对照组的点估计值（分别为 6.6%和 31.3%）。受伤后，39 例患者中有 14 例（36%）永久需要增加助行器，8 例（20%）需要永久性增加日常护理水平。
结果表明，与年龄和性别匹配的未受伤对照组相比，老年人群中低能量模式骨盆支骨折可能会导致更高的死亡率和发病率。
