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Large Joints Feature

Source: Wikimedia Commons and rtruo85

Pelvic Fractures: 1-Year Mortality Same for Young and Old

Elizabeth Hofheinz, M.P.H., M.Ed. • Thu, March 8th, 2018

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A recent retrospective review from a Level 1 academic trauma center has found that there is no difference in one-year mortality rates between the younger and older patient cohorts in high energy trauma cases.

The study, “Mortality After High-Energy Pelvic Fractures in Patients of Age 65 Years or Older,” appears in the March 2018 edition of the Journal of Orthopaedic Trauma.

The authors wrote, “Seventy consecutive patients 65 years of age and older treated for pelvic fracture resulting from high-energy mechanism from 2008 to 2011. A total of 140 patients 18-64 years of age were matched to the study population based on mechanism of injury and OTA [Orthopaedic Trauma Association] Code 61 subtype for comparison.”

Madhav Karunakar, M.D. is with the Department of Orthopaedic Surgery at Carolinas Medical Center in Charlotte, North Carolina. Dr. Karunakar, a co-author on the study, told OTW, “There is currently limited information regarding the one-year mortality for patients age 65 or older who sustain a pelvic fracture resulting from high energy trauma. This study confirms findings from prior studies that have demonstrated a higher in-patient mortality for older patients when compared to a younger cohort.”

The authors wrote, “The overall inpatient mortality rate was 10%. The older cohort exhibited an inpatient mortality rate 3 times higher than the younger cohort. There was no difference in mortality one-year post discharge.”

“However, the more interesting finding from the current study is the lack of difference in one-year mortality between the younger and older patient cohorts. This observation is in contrast to the increased one-year mortality reported after low energy hip fracture. Based on this study, we recommend focusing clinical and research efforts on the acute resuscitation and management of pelvic fractures in this subset of patients in order to identify areas where improvements in care can be made.”

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