Pelvic fracture does not increase mortality in adult trauma patients: A propensity score analysis

Abstract

Background: This study was designed to investigate the impact of pelvic fracture on the outcome of trauma patients. Methods: Detailed data of 512 and 20,159 adult patients with and without pelvic fracture, respectively, hospitalized between January 1, 2009, and December 31, 2015 were retrieved from the Trauma Registry System of a level I regional trauma center. Two-sided Fisher exact or Pearson Chi-square tests were used to compare categorical data. The unpaired Student t-test and Mann–Whitney U-test were used to analyze normally and nonnormally distributed continuous data, respectively. Propensity score matching was performed using NCSS software to evaluate the effect of pelvic fracture on mortality and expenditure. Results: Patients with pelvic fracture presented with a longer hospital stay, a higher likelihood of being admitted to the Intensive Care Unit, and a significantly higher incidence of mortality (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.3–3.5; P = 0.003) than those without pelvic fracture. However, the logistic regression analysis of 316 well-balanced pairs of patients with matched propensity scores (to eliminate the difference in sex, age, comorbidity, Glasgow coma scale, and injury severity score) showed that the association of pelvic fracture did not significantly influence mortality (OR 1.2, 95% CI 0.6–2.5; P = 0.581). Conclusions: This study revealed that the higher odds of mortality in patients with pelvic fracture can be attributed to a combination of multiple injuries to different body regions and risk factors of the patients.

Keywords

• Hospital cost
• in-hospital mortality
• length of stay
• pelvic fracture