Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 East 17th Street Suite 1402, New York, NY, 10003, USA.
Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY, 11418, USA.
Eur J Orthop Surg Traumatol. 2022 Oct;32(7):1379-1384. doi: 10.1007/s00590-021-03125-7. Epub 2021 Sep 20.
The purpose of this study was to examine hospital quality measures and the long-term functional outcomes associated with lateral compression type 1 [LC1] pelvic ring injuries.
A query was performed from December 2011 to September 2020 at two institutions within one hospital system for patients with a pelvic fracture diagnosis. Chart review was performed on admitted patients to determine demographic information, medical co-morbidities (to calculate Charlson Co-morbidity Index), in-hospital complications, length of stay [LOS], discharge disposition, and 30-day readmission rates. All patients included were treated nonoperatively. An attempt was made to contact all patients for long-term follow-up to assess current functional status with a Short Musculoskeletal Function Assessment [SMFA].
Two-hundred and eighty-six patients were included, with 172 (65.9%) patients admitted and analyzed with respect to hospital quality measures. Patients admitted were older (83 vs 80 years, p = 0.015) with more medical co-morbidities (p = 0.001) than those discharged from the emergency department. The average LOS was 5.7 ± 3.7 days and 31 (18%) experienced in-hospital complications. The inpatient mortality rate was 1.2%, and the 30-day readmission rate was 8.1%. When comparing admitted patients without concomitant injuries, admitted patients with concomitant injuries, and non-admitted patients, admitted patients with concomitant injuries were found to have more medical co-morbidities (p = 0.001). Forty-three patients were available for long-term follow-up (average 36.6 ± 7.3 months), with an average SMFA score of 29.0 ± 25.7.
Patients admitted for LC1 pelvic fractures are likely to be older with more medical co-morbidities, and up to 1/5th will experience inpatient complications. Although inpatient mortality remains low, this injury pattern can lead to significant functional disability that persists for several years after injury.
本研究旨在探讨与横向挤压型 1（LC1）骨盆环损伤相关的医院质量指标和长期功能结局。
在一家医院系统的两个机构中，从 2011 年 12 月至 2020 年 9 月进行了一次查询，以确定骨盆骨折诊断的患者。对入院患者进行病历回顾，以确定人口统计学信息、合并症（计算 Charlson 合并症指数）、院内并发症、住院时间（LOS）、出院去向和 30 天再入院率。所有纳入的患者均接受非手术治疗。我们试图联系所有患者进行长期随访，以使用短期肌肉骨骼功能评估（SMFA）评估当前的功能状态。
共纳入 286 例患者，其中 172 例（65.9%）患者接受治疗并分析了与医院质量指标相关的情况。与从急诊室出院的患者相比，住院患者年龄更大（83 岁 vs 80 岁，p=0.015），合并症更多（p=0.001）。平均 LOS 为 5.7±3.7 天，31 例（18%）发生院内并发症。住院死亡率为 1.2%，30 天再入院率为 8.1%。在比较无合并伤的住院患者、有合并伤的住院患者和未住院的患者时，有合并伤的住院患者发现合并症更多（p=0.001）。43 例患者可进行长期随访（平均 36.6±7.3 个月），平均 SMFA 评分为 29.0±25.7。
因 LC1 骨盆骨折住院的患者年龄较大，合并症较多，多达 1/5 的患者会发生院内并发症。尽管住院死亡率仍然较低，但这种损伤模式会导致严重的功能障碍，在受伤后数年持续存在。
