In the initial resuscitation setting, pelvic fracture-related arterial bleeding can be predicted with certain physiologic parameters, according to study results.
Researchers included 143 patients with high-energy pelvic fractures in the prospective cohort study. Data collected included patient demographics, mechanism of injury, vital signs, acid-base status, fluid resuscitation, trauma scores, fracture patterns, procedures and outcomes.
Using univariate analysis, Pearson correlation, receiver operator characteristic and decision tree analysis, the researchers identified potential predictors. Main outcome measures included determination of pelvic fracture-related arterial bleeding (PFRAB) based on angiography or CT angiogram or laparotomy findings.
According to study results, 10% of patients had PFRAB and were found to be significantly older, more severely injured, more hypotensive, more acidotic, more likely to require transfusions in the emergency department and had higher mortality rates compared with non-PFRAB patients.
Although the researchers did not find a single variable to be a strong predictor, some variables had a significant correlation with PFRAB. These included worst base deficit, receiver operator characteristic, difference between any two measures of base deficit within 4 hours greater than 2 mmol/L, transfusion in emergency department and worst systolic blood pressure less than 104 mm Hg. Alternatively, demographics, injury mechanism, fracture pattern, temperature and pH had poor predictive value, according to the researchers.
Disclosure: The authors have no relevant financial disclosures.