Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

• Main Authors: José Gustavo Parreira, Lucas R. Kanamori, Guilherme C. J. Valinoto, Jacqueline A. Giannini Perlingeiro, Silvia Cristine Soldá, José Cesar Assef
• Format: Article
• Language: English
• Published: Colégio Brasileiro de Cirurgiões
• Series: Revista do Colégio Brasileiro de Cirurgiões
• Subjects: Hip fractures; Fractures, closed; Pelvic bones; Prognosis; Trauma severity índices
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912014000400285&lng=en&tlng=en

OBJECTIVE:to identify predictors of death in blunt trauma patients sustaining pelvic fractures and, posteriorly, compare them to a previously reported series from the same center.METHOD: Retrospective analysis of trauma registry data, including blunt trauma patients older than 14 y.o. sustaining pelvic fractures admitted from 2008 to 2010. Patients were assigned into group 1 (dead) or 2 (survivors). We used Student's t, qui square and Fisher's tests for statistical analysis, considering p<0.05 as significant. Posteriorly, we compared predictors of death between both periods.RESULTS: Seventy-nine cases were included. Mean RTS, ISS and TRISS were, respectively, 6.44 + 2.22, 28.0 + 15.2 e 0.74 + 0.33. Nineteen patients died (24,0%). Main cause of death was hemorrhage (42,1%). Group 1 was characterized by (p<0.05) lower systolic blood pressure and Glasgow coma scale means on admission, higher heart rate, head AIS, extremity AIS and ISS means, as well as, higher frequency of severe head injuries and complex pelvic fractures. Comparing both periods, we notice that the anatomic and physiologic severity of injury increased (RTS and ISS means). Furthermore, there was a decrease in the impact of associated thoracic and abdominal injuries on the prognosis and an association of lethality with the presence of complex pelvic fractures.CONCLUSION: There were significant changes in the predictors of death between these two periods. The impact of thoracic and abdominal associated injures decreased while the importance of severe retroperitoneal hemorrhage increased. There was also an increase in trauma severity, which accounted for high lethality.