Thorsen Kenneth, Oord Pieter, Narvestad Jon K, Reite Andreas, Tjosevik Kjell E
Section for Traumatology, Surgical Clinic, Stavanger University Hospital, Stavanger, Norway.
Department of Gastrointestinal Surgery, Stavanger University Hospital, PO Box 8100, N-4068, Stavanger, Norway.
Scand J Trauma Resusc Emerg Med. 2025 Jun 5;33(1):102. doi: 10.1186/s13049-025-01399-y.
Severe pelvic injuries with ISS > 15 is associated with a high degree of morbidity and mortality. We aimed to describe the demography, emergency interventions and outcome of patients with these injuries and analyze changes in practice occurring in this timeframe.
Stavanger University Hospital (SUH) is located in South-Western Norway. All patients registered in the Stavanger University Hospital Trauma registry between 2004-2022 with a pelvic injury and concomitant ISS > 15 were included in this study.
In total 2283 patients with a pelvic injury were included in the trauma registry between 2004-2022. There were 160 patients with an ISS > 15, with 115 (72%) men and 45 (28%) women. Median age of men was 45 years, while women were slightly older at 52 years of age. The 30-day mortality in men (25/115) and women (10/45) was identical at 22%. Emergency intervention was performed in 33/160 (20.1%%) patients. In 27 patients a laparotomy, an EPP or an angioembolization was the primary hemostatic emergency procedure. All but one pelvic packing were done in the years 2010-2014, with one packing also performed in 2021. A significant decline both in number of patients receiving crystalloids and the amount of crystalloids administered, both prehospitally and in the ER were seen when comparing period 1-3. The mortality in the EPP group was very high at 6/8 (75%) while only 1/9 in the laparotomy group succumbed and 2/10 (20%) in the AE group. These discrepancies may be related to the high median ISS of 50 in the pelvic packing group, vs 40 in the angioembolization group vs 38 in the laparotomy group, reflected by a statistically significant difference in probability of survival (TRISS score) between emergency intervention groups (p < 0.001).
Severe pelvic injuries are quite rare, with about 1 incident per month. About 2/3 are men and transport related injuries are the most common mechanism of injury. Patients in need of emergency intervention are characterized by a high median ISS and concomitant high mortality. A significant decline in emergency interventions were seen over time, which may be related to declining infusions of crystalloids and better transfusion protocols.
损伤严重度评分（ISS）>15的严重骨盆损伤与高发病率和死亡率相关。我们旨在描述这些损伤患者的人口统计学特征、急诊干预措施及预后，并分析在此期间实践中的变化。
斯塔万格大学医院（SUH）位于挪威西南部。纳入2004年至2022年在斯塔万格大学医院创伤登记处登记的所有骨盆损伤且ISS>15的患者。
2004年至2022年期间，创伤登记处共纳入2283例骨盆损伤患者。其中ISS>15的患者有160例，男性115例（72%），女性45例（28%）。男性的中位年龄为45岁，女性稍大，为52岁。男性（25/115）和女性（10/45）的30天死亡率均为22%。33/160（20.1%）例患者接受了急诊干预。27例患者的剖腹手术、外部盆腔填塞（EPP）或血管栓塞是主要的止血急诊手术。除1例盆腔填塞外，所有盆腔填塞均在2010年至2014年进行，2021年也进行了1例盆腔填塞。与第1阶段至第3阶段相比，院前和急诊室接受晶体液治疗的患者数量及晶体液使用量均显著下降。EPP组的死亡率非常高，为6/8（75%），而剖腹手术组仅1/9死亡，血管栓塞组为2/10（20%）。这些差异可能与盆腔填塞组的中位ISS为50、血管栓塞组为40、剖腹手术组为38有关，急诊干预组之间的生存概率（TRISS评分）存在统计学显著差异（p<0.001）。
严重骨盆损伤相当罕见，每月约发生1例。约2/3为男性，与交通相关的损伤是最常见的损伤机制。需要急诊干预的患者具有较高的中位ISS和随之而来的高死亡率。随着时间的推移，急诊干预显著减少，这可能与晶体液输注减少和更好的输血方案有关。
