Pelvik kırıkların epidemiyolojik özelliklerinin değerlendirilmesi

Year 2021, Volume: 12 Issue: 3, 249 - 254, 29.09.2021

Nezih Kavak , Evrim Duman , Mesut Tıkman , Ayhan Sumer Yaman

https://doi.org/10.18663/tjcl.941517

Cited By: 1

Abstract

Amaç: Pelvik kırıklı hastaların epidemiyolojik özelliklerini araştırmak.
Gereç ve Yöntemler: Acil serviste (AS) pelvik kırıklı hastaların yaşı, cinsiyeti, komorbid hastalık, başvuru mevsimi, yaralanma mekanizmaları, kırık tipi (Young Burgess sınıflaması), ilişkili yaralanmalar ve mortalite değerlendirildi.
Bulgular: Çalışmaya alınan 919 hastanın 307’ü (%33,4) kadın ve 612’si (%66,6) erkek idi. Ortalama 36,5 ± 14,82 (18-80) yıl idi. Erkeklerin yaş ortalaması 35,1±13,63 yıl, kadınların ise 39,2±16,63 yıl idi. Erkeklerin %46,4 28-37 yıl aralığında yer almakta idi. 254 (%27,6) hastada komorbit hastalık bulunmaktaydı. 302 (%32,9) hasta kış, 285 (%31) hasta yaz mevsimide başvurmuştu. En sık otomobil kazaları 268 (%29,2) sonra yüksekten düşmeler 211 (%23) nedeni ile meydana gelmişti. Otomobil kazaları en sık kış, yüksekten düşmeler ise yaz mevsiminde daha sıktı. Otomobil kazaları, yüksekten düşmeler, motorsiklet kazaları erkeklerde kadınlardan daha sık iken, kendi seviyesinden düşmeler, araç dışı trafik kazaları, diğer yaralanmalar kadınlarda erkeklerden daha sık olarak izlendi (p<0,001). Kendi seviyesinden düşen kadınların yaş ortalaması 62,79 yıl iken, erkeklerin 68,46 yıl idi. En sık 423 (46%) LC1 tespit edildi. 321 (%34,9) hastada abdominal travma, 299 (%32,5) hastada kafa travması eşlik etmekteydi. Seksen (8.7%) hasta AS’de öldü.
Sonuç: Pelvik kırık yaralanmasının en yaygın mekanizmaları otomobil kazaları ve düşmelerdir. Bu kırıklara eşlik eden yaralanmalar sıktır.

Keywords

pelvik kırık, epidemiyoloji, kırık tipi, ilişkili yaralanma

Evaluation of epidemiological characteristics of pelvic fractures

Abstract

Aim: To investigate the epidemiological characteristics of patients with pelvic fractures.
Material and Methods: We evaluated age, gender, comorbid disease, admission season, mechanisms of the injury, type of the fractures (Young Burgess classification), associated injuries, and mortality of patients with pelvic fractures in the emergency department (ED).
Results: Of the 919 patients included in the study, 307 (33.4%) were female and 612 (66.6%) were male. The mean age was 36,5±14,82 (18-80) years. The mean age of males was 35.1 ± 13.63 years, and it was 39.2 ± 16.63 years for females. Of the males, 46.4% were in the 28-37 years range. Comorbid diseases were found in 254 (27.6%) patients. Of the patients, 302 (32.9%) were admitted in winter and 285 (31%) in summer. It was mostly occurred due to automobile accidents 268 (29.2%), followed by falls from height 211 (23%). Automobile accidents were most common in the winter season, while falls from height was more common in the summer. While automobile accidents, falls from height, motorcycle accidents were more common in males compared to females, falls from own height, pedestrians hit by a car, and other injuries were observed more frequently in females than males (p <0.001). While the mean age of females fell from their own height was 62.79 years, it was 68.46 years for males. 423 (46%) LC1 was detected most frequently. It was accompanied by abdominal trauma in 321 (34.9%) patients and head trauma in 299 (32.5%) patients. Eighty (8.7%) patients died in ED.
Conclusion: The most common mechanisms of pelvic fracture injury are automobile accidents and falls. Associated injuries are frequently observed.

Keywords

pelvic fracture, epidemiology, type of fracture, associated injury

References

• 1. Pohlemann T, Stengel D, Tosounidis G, et al. Survival trends and predictors of mortality in severe pelvic trauma: estimates from the German Pelvic Trauma Registry Initiative. Injury. 2011; 42 :997-1002
• 2. Hussami M, Grabherr S, Meuli RA et al. Severe pelvic injury: vascular lesions detected by ante- and post-mortem contrast medium-enhanced CT and associations with pelvic fractures. Int J Legal Med. 2017; 131: 731–38.
• 3. Hermans E, Biert J, Edwards MJR. Epidemiology of pelvic ring fractures in a level 1 trauma center in the Netherlands. Hip Pelvis. 2017; 29: 253–61.
• 4. Hodgson S. AO principles of fracture management. Ann R Coll Surg Engl. 2009; 91: 448-9.
• 5. Ghosh S, Aggarwal S, Kumar V, et al. Epidemiology of pelvic fractures in adults: Our experience at a tertiary hospital. Chin J Traumatol. 2019; 22: 138-41.
• 6. Abdelrahman H, El-Menyar A, Keil H, et al. Patterns, management, and outcomes of traumatic pelvic fracture: insights from a multicenter study. J Orthop Surg Res. 2020; 15: 249.
• 7. Davarinos N, Ellanti P, Morris S, et al. Epidemiology of pelvic and acetabular trauma in a Dublin tertiary hospital: a 10-year experience. Ir J Med Sci. 2012; 181 :243-6.
• 8. Pereira GJC, Damasceno ER, Dinhane DI et al. Epidemiology of pelvic ring fractures and injuries. Rev Bras Ortop. 2017; 52 :260-9.
• 9. Young JW, Burgess AR, Brumback RJ, et al. Pelvic fractures: value of plain radiography in early assessment and management. Radiology. 1986; 160 :445-51
• 10. Riemer BL, Butterfield SL, Diamond DL, et al. Acute mortality associated with injuries to the pelvic ring: the role of early patient mobilization and external fixation. J Trauma. 1993; 35: 671-5
• 11. Demetriades D, Karaiskakis M, Toutouzas K, et al. Pelvic fractures: epidemiology and predictors of associated abdominal injuries and outcomes. J Am Coll Surg. 2002; 195: 1-10.
• 12. Chien LC, Cheng HM, Chen WC, et al. Pelvic Fracture and Risk Factors for Mortality: A Population-Based Study in Taiwan. Eur J Trauma Emerg Surg. 2010; 36: 131-7.
• 13. Lefaivre KA, Padalecki JR, Starr AJ. What constitutes a Young and Burgess lateral compression-I (OTA 61-B2) pelvic ring disruption? A description of computed tomography-based fracture anatomy and associated injuries. J Orthop Trauma. 2009; 23: 16-21.
• 14. Dzupa V, Chmelová J, Pavelka T, et al. Multicentrická studie pacientů s poranením pánve: základní analýza souboru [Multicentric study of patients with pelvic injury: basic analysis of the study group). Acta Chir Orthop Traumatol Cech. 2009; 76: 404-9.
• 15. Hossain A, Islam S, Haque Qasem MF, et al. Epidemiology of pelvic fractures in adult: Our experience at two tertiary care hospital in Dhaka, Bangladesh. J Clin Orthop Trauma. 2020; 11: 1162-7.
• 16. Chueire AG, Filho GC, Santos AF, et al. Fraturas do anel pélvico: estudo epidemiológico. Acta Ortop Bras. 2004; 12: 1–10.
• 17. Kobbe P, Hockertz I, Sellei RMet al. Minimally invasive stabilisation of posterior pelvic-ring instabilities with a transiliac locked compression plate. Int Orthop. 2012; 36: 159-64.
• 18. Ježek M, Džupa V. Vliv věku pacienta a mechanismu úrazu na typ zlomeniny pánve: epidemiologická studie [The influence of patient age and mechanism of injury on the type of pelvic fracture: epidemiological study). Acta Chir Orthop Traumatol Cech. 2012; 79: 65- 8.
• 19. Küper MA, Trulson A, Stuby FM, et al. Pelvic ring fractures in the elderly. EFORT Open Rev. 2019 Jun 3; 4: 313-20.
• 20. Krappinger D, Kammerlander C, Hak DJ, et al. Low-energy osteoporotic pelvic fractures. Arch Orthop Trauma Surg. 2010; 130: 1167-75.
• 21. Parsons N, Odumenya M, Edwards A,et al. Modelling the effects of the weather on admissions to UK trauma units: a cross-sectional study. Emerg Med J. 2011; 28: 851-5.
• 22. Morgan A, Mannering FL. The effects of road-surface conditions, age, and gender on driver-injury severities. Accid Anal Prev. 2011; 43: 1852-63.
• 23. Saha S, Schramm P, Nolan A, et al. Adverse weather conditions and fatal motor vehicle crashes in the United States, 1994-2012. Environ Health. 2016;1 5: 104
• 24. Coleman JR, Moore EE, Vintimilla DR, et al. Association between Young-Burgess pelvic ring injury classification and concomitant injuries requiring urgent intervention. J Clin Orthop Trauma. 2020; 11: 1099-103.
• 25. Palmcrantz J, Hardcastle TC, Naidoo SRet al. Pelvic fractures at a new level 1 trauma centre: who dies from pelvic trauma? The Inkosi Albert Luthuli Central Hospital experience. Orthop Surg. 2012; 4: 216-21.
• 26. Gustavo Parreira J, Coimbra R, et al. The role of associated injuries on outcome of blunt trauma patients sustaining pelvic fractures. Injury. 2000; 31: 677-82.
• 27. Lunsjo K, Tadros A, Hauggaard A, et al. Associated injuries and not fracture instability predict mortality in pelvic fractures: a prospective study of 100 patients. J Trauma. 2007; 62: 687-91.