Yoo Jaeri, Choi Donghwan, Kang Byung Hee
Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
J Trauma Inj. 2024 Mar;37(1):6-12. doi: 10.20408/jti.2023.0063. Epub 2024 Jan 3.
Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures.
Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching.
Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different.
The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.
开放性骨盆骨折相对少见，且被认为比闭合性骨折更严重。本研究旨在比较开放性和闭合性严重骨盆骨折的临床结局。
对2016年至2020年期间在某单一Ⅰ级创伤中心收治的严重骨盆骨折（骨盆简明损伤量表评分≥4）患者进行回顾性分析。年龄<16岁及病历不完整的患者被排除在研究之外。将患者分为开放性骨折组和闭合性骨折组，并在1:2倾向评分匹配前后比较其人口统计学特征、治疗情况和临床结局。
321例患者中，开放性骨折组24例，闭合性骨折组297例。开放性骨折组感染更多（37.5%对5.7%，P<0.001），重症监护病房住院时间更长（中位数11天，四分位数间距[IQR]6 - 30天对中位数5天，IQR 2 - 13天；P = 0.005），但匹配前死亡率无统计学显著差异（20.8%对15.5%，P = 0.559）。1:2倾向评分匹配后，开放性骨折组感染率仍显著更高（37.5%对6.3%，P = 0.002），而重症监护病房住院时间（中位数11天，IQR 6 - 30天对中位数8天，IQR 4 - 19天；P = 0.312）和死亡率（20.8%对27.1%，P = 0.564）无显著差异。
开放性骨盆骨折组比闭合性骨盆骨折组感染更多，但死亡率无显著差异。无论骨折类型如何，积极治疗骨盆骨折都很重要，且在开放性骨盆骨折中努力减少感染很重要。
