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Journal of the Korean Society of Traumatology 2003;16(2):129-135.
Clinical Evaluation of Pelvic Fractur in Geriatric Patients: A Retro's pective Clinical Review of 93 Cases
Hyun Chul Hwang, M.D., Hoon Pyo Hong, M.D., Dong Pil Kim, *M.D., Myung Chun Kim, M.D., Young Gwan Ko, M.D.
Department of Emergency Medicine, KyungHee University Medical College, Seoul, Korea
*Department of Emergency Medicine, Dongsuwon General Hospital, Suwon, Korea
응급실로 내원한 고령의 골반골절 환자의 임상 양상
황현철·홍훈표·김동필·김명천·고영관
경희대학교 의과대학 응급의학교실
Abstract
Purpose
This study was performed to review our experience with geriatric pelvic fracture patients in our emergency center. Methods: Pelvic bone fracture patients who visited the emergency center of Kyung Hee University Hospital and Dongsuwon General Hospital from March 2001 to July 2003 were analyzed using a retrospective medical records review. Variables included in the data analysis were demographics, injury pattern, transfusion needs, and outcome of pelvic fractures in older versus younger patients. Results: We cared for 93 patients with pelvic fractures during the study period. The mean age was 38 years, 56% were men, and the mean Injury Severity Score (ISS) was 19. Overall mortality was 13%. Seventy-five percent were younger than 55 years, and 25% were older than 55 years. Severe pelvic fractures were more common in older patients. The initial systolic blood pressure was lower and the heart rate higher in older patients, although the ISS was not different between the two age groups. Older patients were 2.2 times as likely to undergo transfusion and those undergoing transfusion, required more blood. Lateral compression (LC) fractures occurred 2.7 times more frequently in older patients than anteroposterior (AP) compression fractures. Conclusion: In older patients, pelvic fractures are more likely to produce severe complications and sequelae. Fracture patterns differ in older patients, with LC fractures occurring more frequently and commonly causing significant blood loss. The outcome for older patients with pelvic fractures is significantly worse than it is for younger patients, particularly for higher injury severity. Recognition of these differences should help clinicians to identify patients at high risk for bleeding and death early and to refine diagnostic and resuscitation strategies.
Key Words: Pelvic bone fracture; Geriatric patients


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