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Affiliation
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* University of North Carolina School of Medicine, Chapel Hill, NC † Illinois Bone & Joint Institute, Barrington, IL § Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC. |
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Abstract
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OBJECTIVES: To document in-hospital and 1-year mortality rates following high-energy pelvic fracture in patients age 65 or older as compared to a younger cohort.
DESIGN: Retrospective review. SETTING: Urban level 1 academic trauma center. PATIENTS: Seventy consecutive patients age ≥ 65 years treated for pelvic fracture resulting from high-energy mechanism from 2008 to 2011. One hundred forty patients age 18-64 were matched to the study population based on mechanism of injury and OTA Code 61 subtype for comparison. INTERVENTION: Review of demographics, injury characteristics, hospital management, and mortality. MAIN OUTCOME MEASUREMENTS: Mortality.
RESULTS: The overall inpatient mortality rate was 10%. The older cohort exhibited an inpatient mortality rate three 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 Co-morbidity Index (CCI) (p=0.012) and 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.
CONCLUSIONS: After controlling for mechanism of injury and pelvic fracture classification, we found that adults ≥ 65 and those with multiple co-morbidities were more likely to die in the hospital than younger adults. However, mortality within 1-year post-discharge was low and did not differ between groups. This is in sharp contrast to the high rates of post-discharge mortality observed in elderly patients with hip fracture. LEVEL OF EVIDENCE: Retrospective Cohort Study, Level III.
Language: en |