Risk Factors Associated with Mortality of Patients with Pelvic Fractures and Hemodynamic Instability in a Korean Trauma Center

BackgroundThis study aimed to compare treatment outcomes between patients with severe pelvic fractures treated at a representative trauma center that was established in Korea since 2015 and matched cases treated in the USA.MethodsTwo cohorts were selected from a single institution trauma database in South Korea (Ajou Trauma Data Bank (ATDB)) and the National Trauma Data Bank (NTDB) in the USA. Adult blunt trauma patients with a pelvic Abbreviated Injury Scale >3 were included. Patients were matched based on covariates that affect mortality rate using a 1:1 propensity score matching (PSM) approach. We compared differences in outcomes between the two groups, performed survival analysis for the cohort after PSM and identified factors associated with mortality. Lastly, we analyzed factors related to outcomes in the ATDB dataset comparing a period prior to the implementation of the trauma center according to US standards, an interim period and a postimplementation period.ResultsAfter PSM, a total of 320 patients (160 in each cohort) were identified for comparison. Inhospital mortality was significantly higher in the ATDB cohort using χ2 test, but it was not statistically significant when using Kaplan-Meier survival curves and Cox regression analysis. Moreover, the mortality rate was similar comparing the NTDB cohort to ATDB data reflecting the post-trauma center establishment period. Older age, lower systolic blood pressure (SBP) and Glasgow Coma Scale (GCS) at admission were factors associated with mortality.DiscussionMortality rate after severe pelvic fractures was significantly associated with older age, lower SBP and GCS scores at admission. Efforts to establish a trauma center in South Korea led to improvement in outcomes, which are comparable to those in US centers.Level of evidenceLevel IV.

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Risk Factors Associated with Hemodynamic Instability during Stent Implantation in Unprotected Left Main Lesions without Routine IABP: Identification of the High Risk Patients

Korean Circulation Journal ◽

10.4070/kcj.2007.37.3.108 ◽

2007 ◽

Vol 37 (3) ◽

pp. 108

Author(s):

Woong Kim ◽

Jong-Seon Park ◽

Sang-Hee Lee ◽

Geu-Ru Hong ◽

Dong-Gu Shin ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Stent Implantation ◽

Hemodynamic Instability ◽

Left Main ◽

Factors Associated ◽

High Risk Patients ◽

Risk Patients

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Risk factors associated with bladder and urethral injuries in female children with pelvic fractures

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000000947 ◽

2016 ◽

Vol 80 (3) ◽

pp. 472-476 ◽

Cited By ~ 7

Author(s):

Kristen M. Delaney ◽

Srinivas H. Reddy ◽

Anand Dayama ◽

Melvin E. Stone ◽

James A. Meltzer

Keyword(s):

Risk Factors ◽

Pelvic Fractures ◽

Factors Associated ◽

Female Children ◽

Urethral Injuries

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Risk Factors Associated with Lower Urinary Tract Injuries in Traumatic Pelvic Fractures

Medical & Surgical Urology ◽

10.4172/2168-9857.1000188 ◽

2017 ◽

Vol 06 (02) ◽

Author(s):

Vaite Tsing ◽

Jessica NG ◽

Martin Wullschleger

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Lower Urinary Tract ◽

Pelvic Fractures ◽

Factors Associated ◽

Lower Urinary

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Improvement of outcomes in patients with pelvic fractures and hemodynamic instability after the establishment of a Korean regional trauma center

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-017-0886-3 ◽

2017 ◽

Vol 45 (1) ◽

pp. 107-113 ◽

Cited By ~ 3

Author(s):

Ji Young Jang ◽

Hongjin Shim ◽

Hye Youn Kwon ◽

Hoejeong Chung ◽

Pil Young Jung ◽

...

Keyword(s):

Trauma Center ◽

Hemodynamic Instability ◽

Pelvic Fractures

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Risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall

Aging Clinical and Experimental Research ◽

10.1007/s40520-016-0579-5 ◽

2016 ◽

Vol 29 (3) ◽

pp. 427-433 ◽

Cited By ~ 5

Author(s):

L. J. Cartagena ◽

A. Kang ◽

S. Munnangi ◽

A. Jordan ◽

I. C. Nweze ◽

...

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Hospital Mortality ◽

Trauma Center ◽

Factors Associated

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Comparison of mortality according to hemorrhage control methods performed for hemodynamically unstable patients with traumatic pelvic fractures: A multi-center study

10.21203/rs.3.rs-30761/v1 ◽

2020 ◽

Author(s):

Myoung Jun Kim ◽

Seung Hwan Lee ◽

Ji Young Jang ◽

Jae Gil Lee

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Hemodynamic Instability ◽

Pelvic Fractures ◽

Control Methods ◽

Multivariate Logistic Regression ◽

Hemorrhage Control ◽

Acute Hemorrhage ◽

Significant Difference ◽

Independent Risk Factors

Abstract Background: We analyzed the effects of hemorrhage control methods on the mortality of patients with hemodynamic instability due to pelvic fracture and investigated independent risk factors for mortality in these patients.Methods : A total of 97 pelvic bone fracture patients with hemodynamic instability who visited the emergency departments of two university hospitals from January 2013 to October 2017 were enrolled. These patients were divided into the survival and non-survival groups based on 28-day mortality and acute hemorrhage mortality. Clinical data including laboratory test results, trauma severity scores, and hemorrhage control modalities were collected and statistically analyzed. Furthermore, the effects of each hemorrhagic control modality on mortality were analyzed. Multivariate logistic regression was performed to determine independent risk factors for mortality.Results: Overall mortality was 41.24% (40 patients), 28-day mortality was 38.14% (37 patients), and acute hemorrhage mortality was 28.86% (28 patients). With respect to hemorrhage control modalities, 47 patients (48.5%) underwent pelvic angiography, 45 patients (46.4%) underwent pre-peritoneal pelvic packing, and 19 patients (19.6%) underwent external fixation. Differences in hemorrhage control methods had no significant effects on mortality. However, there was a significant difference in mortality between the groups with and without any hemorrhage control methods. A multivariate logistic regression analysis revealed that patient age, trauma and injury severity score (TRISS; probability of survival), and transfusion amount within 24 hours were independent factors for 28-day mortality. Using the same statistical analysis, patient age, transfusion amount within 24 hours, Glasgow coma scale (GCS) score, and systolic blood pressure (SBP) were independent factors for mortality due to acute hemorrhage.Conclusions: Hemorrhage control methods can aid in reducing acute hemorrhage mortality in hemodynamically unstable patients with pelvic fractures; nevertheless, no significant difference in mortality according to different hemorrhage control methods was found. Older age, higher transfusion requirements, low TRISS scores, GCS scores, and SBP are independent risk factors for mortality in pelvic fracture patients with hemodynamic instability.

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Risk Factors Associated with Mortality in Severe Chest Trauma Patients Admitted to the ICU

Journal of Clinical Medicine ◽

10.3390/jcm11010266 ◽

2022 ◽

Vol 11 (1) ◽

pp. 266

Author(s):

Jesús Abelardo Barea-Mendoza ◽

Mario Chico-Fernández ◽

Manuel Quintana-Díaz ◽

Jon Pérez-Bárcena ◽

Luís Serviá-Goixart ◽

...

Keyword(s):

Risk Factors ◽

Chest Trauma ◽

Multiorgan Failure ◽

Kidney Injury ◽

Hemodynamic Instability ◽

Trauma Patients ◽

Abbreviated Injury Scale ◽

Factors Associated ◽

Severity Of Injury ◽

Multicenter Registry

Our objective was to determine outcomes of severe chest trauma admitted to the ICU and the risk factors associated with mortality. An observational, prospective, and multicenter registry of trauma patients admitted to the participating ICUs (March 2015–December 2019) was utilized to collect the patient data that were analyzed. Severe chest trauma was defined as an Abbreviated Injury Scale (AIS) value of ≥3 in the thoracic area. Logistic regression analysis was used to evaluate the contribution of severe chest trauma to crude and adjusted ORs for mortality and to analyze the risk factors associated with mortality. Overall, 3821 patients (39%) presented severe chest trauma. The sample’s characteristics were as follows: a mean age of 49.88 (19.21) years, male (77.6%), blunt trauma (93.9%), a mean ISS of 19.9 (11.6). Crude and adjusted (for age and ISS) ORs for mortality in severe chest trauma were 0.78 (0.68–0.89) and 0.43 (0.37–0.50) (p < 0.001), respectively. In-hospital mortality in the severe chest trauma patients without significant traumatic brain injury (TBI) was 5.63% and was 25.71% with associated significant TBI (p < 0.001). Age, the severity of injury (NISS and AIS-head), hemodynamic instability, prehospital intubation, acute kidney injury, and multiorgan failure were risk factors associated with mortality. The contribution of severe chest injury to the mortality of trauma patients admitted to the ICU was very low. Risk factors associated with mortality were identified.

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