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Low-impact pelvic fractures in the emergency department

Published online by Cambridge University Press:  21 May 2015

Greg Dodge  and
Rob Brison
Greg Dodge
Affiliation:
Department of Emergency Medicine, Queen's University, Kingston, Ont.
Rob Brison*
Affiliation:
Department of Emergency Medicine, Queen's University, Kingston, Ont.
*
Kingston General Hospital, 76 Stuart St., Kingston ON K7L 2V7; [email protected]

Abstract

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Objective:

We examined the records of patients presenting to the emergency department (ED) with low-impact pelvic fractures. We describe frequency, demographics, management and patient outcomes in terms of ambulatory ability, living independence and mortality.

Methods:

Patients treated for a pelvic fracture over a 2-year period in Kingston, Ont., were identified. We performed a retrospective hospital record review to distinguish high- versus low-impact injury mechanisms, and to characterize the injury event, ED management and outcomes for patients with low-impact fractures.

Results:

Of 132 pelvic fractures identified, 77 were low-impact fractures. Patients were predominantly women (82%) with a mean age of 81 years; 96% had some pre-existing medical comorbidity. The pubic rami were most commonly involved (86%). The median length of stay in the ED was 9.4 hours. Twenty-five patients (32%) were admitted to hospital. Ten patients had surgical stabilization, mostly of the acetabulum. Five patients died in hospital, 4 from pneumonia and 1 from myocardial infarction. Eight additional patients died within 1 year of injury. At discharge, only 18% lived independently and 16% walked without aids versus 42% and 38%, respectively, before injury.

Conclusion:

Low-impact pelvic fractures affect predominantly elderly women with pre-existing comorbidities. A substantial amount of time and resources in the ED are used during the workup of these patients and while awaiting their disposition from the ED. These injuries are important because they affect independence and seem associated with an increased risk of death.

Keywords

pelvic fracturelow-impact traumaoutcomesfalls in elderlymorbiditymortality
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 12 , Issue 6 , September 2010 , pp. 509 - 513
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

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