Standardised multidisciplinary protocol for haemodynamically unstable pelvic fractures

J Orthop Surg (Hong Kong). 2014 Aug;22(2):177-80. doi: 10.1177/230949901402200212.

Abstract

Purpose: To review treatment results of 29 patients with haemodynamically unstable pelvic fractures after implementation of a standardised multidisciplinary protocol.

Methods: Records of 14 men and 15 women aged 14 to 84 (mean, 46) years who were treated for haemodynamically unstable closed (n=27) or open (n=2) pelvic fractures were reviewed. The survival rates before and after implementation of a standardised protocol were compared.

Results: Of these 29 patients, 19 survived, 6 died of exsanguination, and 4 died of multi-organ failure. Survival was significantly improved after implementation of the protocol (66% vs. 31%, p=0.0006).

Conclusion: A standardised protocol involving a dedicated multidisciplinary team for management of haemodynamically unstable pelvic fractures improved survival.

Keywords: fracture fixation; pelvis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Protocols
  • Female
  • Fractures, Bone / complications
  • Fractures, Bone / mortality
  • Fractures, Bone / therapy*
  • Humans
  • Hypotension / complications
  • Hypotension / mortality
  • Hypotension / therapy*
  • Male
  • Middle Aged
  • Patient Care Team*
  • Pelvic Bones / injuries*
  • Retrospective Studies
  • Trauma Severity Indices
  • Treatment Outcome
  • Young Adult