Journal article
Hypotension in the Emergency Department and Contrast Extravasation on Computerized Tomography Predict Blood Transfusion in Pelvic Fractures
The Journal of surgical research, v 296, pp 310-315
01 Apr 2024
PMID: 38306936
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction: Although low-energy pelvic fractures seldom present with significant hemorrhage, early recognition of at-risk patients is essential. We aimed to identify predictors of transfusion requirements in this cohort. Methods: A 7-y retrospective chart review was performed. Low-energy mechanism was defined as falls of <5 feet. Fracture pattern was classified using the Orthopedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen system as A, B, or C. Primary outcome was transfusion of >= 2 units of packed red blood cells in the first 48 h. Univariable analysis and logistic regression analysis were performed. A P value <0.05 was considered significant. Results: Five hundred forty six patients were included with median (interquartile range) age of 86 (79-91) and median (interquartile range) Injury Severity Score of 5 (4-8). Five hundred forty one (99%) had type A fractures. Twenty six (5%) had the primary outcome and 17 (3%) died. Logistic regression found that systolic blood pressure <100 mmHg at any time in the Emergency Department, Injury Severity Score, and pelvic angiography were predictors of the primary outcome. Seventeen percent of those who had the primary outcome died compared with 2% who did not (P = 0.0004). Three hundred sixty four (67%) received intravenous contrast for computerized tomography scans and of these, 44 (12%) had contrast extravasation (CE). CE was associated with the primary outcome but not mortality. Conclusions: Hypotension at any time in the Emergency Department and CE on computerized tomography predicted transfusion of >= 2 units packed red blood cells in the first 48 h in patients with low-energy pelvic fractures. (c) 2024 Elsevier Inc. All rights reserved.
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Details
- Title
- Hypotension in the Emergency Department and Contrast Extravasation on Computerized Tomography Predict Blood Transfusion in Pelvic Fractures
- Creators
- Amba Viswanathan - Drexel UniversityHee Yun Na - Drexel UniversityLeigham Breckenridge - Reading HospitalAlison Muller - Reading HospitalChristopher Butts - Reading HospitalEugene Reilly - Reading HospitalThomas Geng - Reading HospitalAdam Sigal - Reading HospitalRyan Michels - Reading HospitalAdrian Ong - Reading Hospital
- Publication Details
- The Journal of surgical research, v 296, pp 310-315
- Publisher
- Elsevier
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001178458400001
- Scopus ID
- 2-s2.0-85184081061
- Other Identifier
- 991021929441904721
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- Web of Science research areas
- Surgery