Assessment of Volume of Hemorrhage and Outcome From Pelvic Fracture

Authors:
  • GJGregory J. Jurkovich
    Gregory J. Jurkovich
  • KLKen F. Linnau
    Ken F. Linnau
  • PCPeter Cummings
    Peter Cummings
  • EHEric K. Hoffer
    Eric K. Hoffer
  • FRFrederick P. Rivara
    Frederick P. Rivara
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Abstract
HEMORRHAGE IN patients with traumatic pelvic fracture remains a diagnostic and treatment challenge. Up to 52% of patients with pelvic fracture will develop hemorrhagic shock in the emergency department1 and 8% to 30% will die in the hospital.1-5 Several investigations have tried to define clinical predictors to determine which patients with pelvic fracture are at high risk for major hemorrhage and thus might benefit from early intervention, such as angiography and embolization.2,6-8 However, studies have been limited by the fact that mortality and blood loss may not be directly or exclusively related to the pelvic fracture.1,5,9 Patients who sustain pelvic fractures are generally victims of high-energy trauma and have multiple injuries involving different organ systems. To guide interventions such as angiography and embolization, predictors of hemorrhage in patients with pelvic fracture should specifically predict hemorrhage related to the pelvic vasculature. We hypothesized that computed tomographic (CT) evaluation of pelvic hematoma in patients with pelvic fracture could help predict fracture-related blood loss and the need for angiography and embolization.

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