• J Orthop Trauma · Mar 2018

    Mortality After High-Energy Pelvic Fractures in Patients of Age 65 Years or Older.

    • Dayley S Keil, Steven Gross, Rachel B Seymour, Stephen Sims, and Madhav A Karunakar.
    • University of North Carolina School of Medicine, Chapel Hill, NC.
    • J Orthop Trauma. 2018 Mar 1; 32 (3): 124-128.

    ObjectivesTo document in-hospital and 1-year mortality rates after high-energy pelvic fracture in patients 65 years of age or older as compared to a younger cohort.DesignRetrospective review.SettingUrban Level 1 academic trauma center.PatientsSeventy consecutive patients 65 years of age and older treated for pelvic fracture resulting from high-energy mechanism from 2008 to 2011. A total of 140 patients 18-64 years of age were matched to the study population based on mechanism of injury and OTA Code 61 subtype for comparison.InterventionReview of demographics, injury characteristics, hospital management, and mortality.Main Outcome MeasurementsMortality.ResultsThe overall inpatient mortality rate was 10%. The older cohort exhibited an inpatient mortality rate 3 times higher than the younger cohort (18.6% vs. 5.7%, P = 0.003). There was no difference in mortality 1 year post discharge (5.3% vs. 3.8%, P = 0.699). No significant differences in initial Glasgow Coma Scale or Injury Severity Score were identified (GCS 12.9 vs. 12.4, P = 0.363; ISS 24.7 vs. 23.4, P = 0.479). Multivariate analysis identified the Charlson Comorbidity Index (CCI) (P = 0.012) and Abbreviated Injury Scale (AIS)-chest (P = 0.005) as independent predictors of in-hospital mortality, and CCI (0.005) and AIS-abdomen (0.012) for 1-year mortality.ConclusionsAfter controlling for mechanism of injury and pelvic fracture classification, we found that adults ≥65 and those with multiple comorbidities were more likely to die in the hospital than younger adults. However, mortality within 1-year postdischarge was low and did not differ between groups. This is in sharp contrast to the high rates of postdischarge mortality observed in elderly patients with a hip fracture.Level Of EvidencePrognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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