Improvement in institutional protocols leads to decreased mortality in patients with haemodynamically unstable pelvic fractures

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

34 Scopus Citations
View graph of relations

Author(s)

  • Mina Cheng
  • Moon-Tong Cheung
  • Kin-Yan Lee
  • Kin-Bong Lee
  • Susan-C. H. Chan
  • Amy-C. Y. Wu
  • Yu-Fat Chow
  • Annice-M.L. Chang
  • Hiu-Fai Ho

Related Research Unit(s)

Detail(s)

Original languageEnglish
Pages (from-to)214-220
Journal / PublicationEmergency Medicine Journal
Volume32
Issue number3
Online published10 Dec 2013
Publication statusPublished - Mar 2015

Abstract

Background The mortality rate in patients with haemodynamically unstable pelvic fractures is as high as 40-60%. In recent years, angioembolisation and pelvic packing have been introduced as part of a multimodality treatment for these patients. Protocol-driven management has been shown to improve outcomes. Patients and methods This is a Level III retrospective cohort study of patients suffering from unstable pelvic fractures from 1 January 1996 to 30 September 2011. The aim of the study was to review our results, particularly in terms of mortality through the evolution of three phases of treatment protocols: preangiography, angiography and pelvic packing. Results The overall 30-day mortality rate for all patients was 47.2%, with a rate of 63.5% in the preangiography phase, 42.1% in the angiography phase and 30.6% in the pelvic packing phase. Multivariate logistic regression analysis identified the use of retroperitoneal packing as a significant independent predictive factor for 24 h mortality. Conclusions Our results showed an improvement in patient survival with sequential protocols over the study period, during which we incorporated a multidisciplinary approach to managing these complicated pelvic fractures. The results strongly suggest that retroperitoneal packing should be highly recommended for bleeding subsequent to pelvic fracture, in addition to other modalities of treatment.

Citation Format(s)

Improvement in institutional protocols leads to decreased mortality in patients with haemodynamically unstable pelvic fractures. / Cheng, Mina; Cheung, Moon-Tong; Lee, Kin-Yan; Lee, Kin-Bong; Chan, Susan-C. H.; Wu, Amy-C. Y.; Chow, Yu-Fat; Chang, Annice-M.L.; Ho, Hiu-Fai; Yau, Kelvin-K.W.

In: Emergency Medicine Journal, Vol. 32, No. 3, 03.2015, p. 214-220.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review