Ruzon Uheyna Gancedo, Da Silva Thayná Caroline, Uliana Christiano Saliba, Rampazzo Matheus Senedese, Cruz Rodrigo Sippel, Pimentel Silvania Klug
Complexo Hospitalar do Trabalhador, Curitiba, PR, Brazil.
Eur J Orthop Surg Traumatol. 2025 Mar 7;35(1):99. doi: 10.1007/s00590-025-04213-8.
High-energy polytrauma can be presented as an abdominal injury associated with a pelvic ring fracture. In the case of concomitant pelvic ring fracture peritoneostomy at admission, high morbidity and mortality rates could be expected.
The main objective of this study is to assess prognostic factors that could contribute to the outcome of polytrauma patients who presented with pelvic ring fractures and were submitted to a peritoneostomy at admission. As a secondary aim, the functional outcome of the survivors was evaluated.
A retrospective, cross-sectional, observational study was conducted. Polytrauma patients who were submitted to a peritoneostomy at admission due to high-energy abdominal injury and presented with concomitant pelvic ring fracture were included. Demographics data and prognostic factors related to "death" and infection were assessed. We applied the Majeed score for functional evaluation.
A total of 29 patients were included in the study. The mortality rate was 58.6% (n = 17). Considering only patients older than 45 years, the death rate was 90%. The variables with positive correlation to death were: (1) age > 45 years (p < 0.017) and (2) the absence of internal fixation (p < 0.011). Patients undergoing internal fixation had more infection rates (60%) compared to noninternal fixation group (11%) (p < 0.011). The average Majeed score was 54.7 points.
The predictive factors associated with increased mortality were age greater than 45 years and the absence of internal fixation. Concomitant pelvic ring fracture and peritoneostomy in admission implicate on high mortality and morbidity rates.
高能多发伤可表现为与骨盆环骨折相关的腹部损伤。若入院时伴有骨盆环骨折且行剖腹术，预计发病率和死亡率会很高。
本研究的主要目的是评估可能影响伴有骨盆环骨折且入院时行剖腹术的多发伤患者预后的因素。次要目的是评估幸存者的功能结局。
进行了一项回顾性、横断面观察性研究。纳入因高能腹部损伤入院行剖腹术且伴有骨盆环骨折的多发伤患者。评估人口统计学数据以及与“死亡”和感染相关的预后因素。我们应用马吉德评分进行功能评估。
本研究共纳入29例患者。死亡率为58.6%（n = 17）。仅考虑年龄大于45岁的患者，死亡率为90%。与死亡呈正相关的变量为：（1）年龄>45岁（p < 0.017）和（2）未行内固定（p < 0.011）。与非内固定组（11%）相比，行内固定的患者感染率更高（60%）（p < 0.011）。马吉德评分平均为54.7分。
与死亡率增加相关的预测因素为年龄大于45岁和未行内固定。入院时伴有骨盆环骨折和剖腹术意味着高死亡率和发病率。
