Abstract
Objective. The elderly population is currently the fastest growing sector in America. The purpose
of this study was to examine the age-related outcome in patients after blunt pelvic
injury. Methods. All patients admitted with a pelvic fracture during a 5-year period were identified
from the trauma registry. Data retrieval included: demographics, shock (BP < 90 mm
Hg) on admission, injury severity score (ISS), abbreviated injury score (AIS) for
head, chest, and abdomen, intensive care unit (ICU) length of stay (LOS), hospital
LOS, and mortality. All pelvic fracture patterns were classified. Patient data were
then stratified by age for comparison: young (< 55 years) and elderly (≥ 55 years).
Statistical analysis was performed using the Student t test, Wilcoxon rank-sum test,
multiple logistic regression analysis, and chi-square test with significance set at
P <.05. Results. Three hundred five patients sustained a pelvic fracture (young [n = 248, 81.3%];
elderly [n = 57, 18.7%]). The only predictor of mortality was age. The 2 groups differed
by gender (elderly = 54.4% females; young = 62.5% males) but not frequency of shock,
ISS, or AIS for head, chest, and abdomen. Motor vehicle collision was the most common
mechanism of injury (elderly = 68.4%; young = 73.8%). Lateral compression was the
most common fracture pattern in both groups (elderly = 54.4%; young = 45.6%). There
was no difference in transfusion (elderly = 2.5 ± 0.7 vs young = 2.0 ± 0.3; ns) but
the elderly group was more frequently admitted to the ICU (elderly = 61.4% vs young
= 46.8%; P =.065). Significantly more of the elderly group had a diagnosis of cardiovascular
disease (43.9% vs 10.1%, P <.001) and diabetes mellitus (10.5% vs 2.4%, P <.014). Mortality was significantly greater in the elderly group (12.3% vs 2.3%).
Conclusion. Elderly patients sustaining a pelvic fracture were more likely to have a lateral
compression fracture pattern, longer hospital LOS, and die despite aggressive resuscitation.
This difference in outcome should help trauma surgeons recognize that the elderly
patient sustaining a pelvic fracture is at increased risk of death. (Surgery 2002;132:710-5.)
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Article info
Footnotes
*Reprint Requests: Fred A. Luchette, MD, Division of Trauma/Critical Care/Burns, Department of Surgery, Loyola University Stritch School of Medicine, 2160 S First Ave, Maywood, IL 60153.
Identification
Copyright
© 2002 Published by Elsevier Inc.
