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Epidemiologic study on pelvic ring injuries : an evaluation based on a tertiary portuguese trauma center
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Introdução: As fraturas pélvicas são lesões complexas e potencialmente fatais, com uma significativa morbi-mortalidade. Estudos epidemiológicos são essenciais na caracterização destas lesões, ajudando no desenvolvimento de protocolos avaliação e orientação terapêutica. Neste trabalho, os autores avaliaram uma coorte de doentes com lesões do anel pélvico, assim como lesões associadas, tratadas num único Centro de Trauma Nível III, entre Janeiro de 2014 e Dezembro de 2021.
Metodologia: Foram identificados 81 doentes que corresponderam aos critérios de inclusão. Dados epidemiológicos relevantes foram obtidos através dos registos médicos, sendo as fraturas classificadas com base em radiografias e tomografias computorizadas de acordo com a classificação de Tile. A análise estatística dos dados foi realizada recorrendo ao software SPSS versão 29.0.
Resultados: Foram identificados 34 mulheres (42%) e 47 homens (58%), com idade média de 44,12 anos. Os acidentes rodoviários constituíram o principal mecanismo lesional, seguidos de quedas em altura. O tempo médio até à cirurgia definitiva foi de 8,6 ± 6,14 dias, mantendo-se estável ao longo dos anos estudados. Fraturas tipo B foram mais comuns na análise radiográfica, enquanto fraturas tipo C foram frequentemente reveladas pela tomografia computorizada, com 50,6% das fraturas apresentando discrepâncias entre os dois métodos de imagem. 6,2% dos doentes apresentavam choque hipovolémico na admissão, enquanto 88% dos doentes com lesões pélvicas registaram lesões associadas, principalmente fraturas nos membros inferiores, com 60,5% coorte a necessitar permanência em unidades de cuidados intensivos.
Conclusão: Fraturas do anel pélvico são mais comuns em homens jovens envolvidos em acidentes de tráfego. Fraturas do Tipo B em radiografia convencional foram frequentemente reclassificadas como Tipo C em tomografia computadorizada. A maioria dos doentes requereu internamento nos cuidados intensivos, com alguns apresentando choque hemorrágico na admissão. A maioria dos pacientes com lesões
pélvicas apresentou outras fraturas associadas, sendo mais comuns as fraturas do membro inferior.
Introduction: Pelvic fractures are complex and life-threatening injuries with significant mortality and morbidity. By analyzing outcomes and management approaches over time, epidemiological studies play a critical role in characterizing these injuries helping the development of treatment protocols. This retrospective study evaluated unstable pelvic ring fractures and associated injuries in patients treated at a single Level III Trauma Center between January 2014 and December 2021. Methods: 81 patients met the desired criteria. Relevant epidemiologic data was retrieved from medical records, and pelvic ring fractures were classified using Tile classification based on x-rays and CT-scans. Data analysis was performed with descriptive statistics using SPSS software version 29.0. Results: The population studied consisted of 34 females (42%) and 47 males (58%), with an average age of 44.12 years. Road traffic accidents were the leading cause of injury, followed closely by falls from height. The average waiting time until definitive surgery was 8,6 ± 6,14 days, remaining stable over the years. Type B fractures were more common on X-rays, while Type C fractures were more common on CT-scans, with 50.6% of fractures showing discrepancies between the two imaging methods. 6,2% of patients experienced hemorrhagic shock at presentation and 88% of patients with pelvic ring fractures had associated injuries, mainly lower limb fractures, with a significant number of patients (60.5%) requiring intensive care unit (ICU) admission. Conclusion: Pelvic ring fractures were more common in males, especially among younger individuals involved in traffic accidents. Type B pelvic ring fractures in X-rays were frequently reclassified as Type C when evaluated with CT scans. ICU stays were often necessary for managing these fractures, with some patients presenting with hemorrhagic shock. Patients with pelvic ring fractures frequently presented multiple associated injuries, with fractures of the lower limbs being one of the most common.
Introduction: Pelvic fractures are complex and life-threatening injuries with significant mortality and morbidity. By analyzing outcomes and management approaches over time, epidemiological studies play a critical role in characterizing these injuries helping the development of treatment protocols. This retrospective study evaluated unstable pelvic ring fractures and associated injuries in patients treated at a single Level III Trauma Center between January 2014 and December 2021. Methods: 81 patients met the desired criteria. Relevant epidemiologic data was retrieved from medical records, and pelvic ring fractures were classified using Tile classification based on x-rays and CT-scans. Data analysis was performed with descriptive statistics using SPSS software version 29.0. Results: The population studied consisted of 34 females (42%) and 47 males (58%), with an average age of 44.12 years. Road traffic accidents were the leading cause of injury, followed closely by falls from height. The average waiting time until definitive surgery was 8,6 ± 6,14 days, remaining stable over the years. Type B fractures were more common on X-rays, while Type C fractures were more common on CT-scans, with 50.6% of fractures showing discrepancies between the two imaging methods. 6,2% of patients experienced hemorrhagic shock at presentation and 88% of patients with pelvic ring fractures had associated injuries, mainly lower limb fractures, with a significant number of patients (60.5%) requiring intensive care unit (ICU) admission. Conclusion: Pelvic ring fractures were more common in males, especially among younger individuals involved in traffic accidents. Type B pelvic ring fractures in X-rays were frequently reclassified as Type C when evaluated with CT scans. ICU stays were often necessary for managing these fractures, with some patients presenting with hemorrhagic shock. Patients with pelvic ring fractures frequently presented multiple associated injuries, with fractures of the lower limbs being one of the most common.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Fraturas do anel pélvico Estudo epidemiológico Politraumatismo Ortopedia