Management and outcomes of severe pelvic fractures in level I and II ACS verified trauma centers
The aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified trauma centers. ACS-TQIP database study, including patients with blunt, isolated severe pelvic facture (AIS 3–5). 2629 level I and 1277 level II patients we...
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Published in | The American journal of surgery Vol. 222; no. 1; pp. 227 - 233 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Elsevier Inc
01.07.2021
Elsevier Limited |
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Abstract | The aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified trauma centers.
ACS-TQIP database study, including patients with blunt, isolated severe pelvic facture (AIS 3–5).
2629 level I and 1277 level II patients were included. Early blood product transfusion was significantly higher, pharmacological VTE prophylaxis significantly lower and ICU length of stay significantly longer in level II centers (p < 0.001). On multivariate analysis, treatment at level II centers was independently associated with increased overall complications, specifically ARDS, but not mortality.
In isolated severe pelvic fractures there was a significantly higher use of early blood products, less VTE pharmacological prophylaxis, longer ICU length of stay and higher overall complications and ARDS in level II centers. Blood product utilization and pharmacological VTE prophylaxis are potential areas of quality improvement in level II centers.
•Higher overall complications in level II centers in isolated severe pelvic fractures.•Significantly higher use of early blood product in level II centers.•More consequent use of LMWH as VTE prophylaxis in level I centers.•Blood product use and VTE prophylaxis as potential areas of quality improvement in level II centers. |
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AbstractList | BackgroundThe aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified trauma centers.MethodsACS-TQIP database study, including patients with blunt, isolated severe pelvic facture (AIS 3–5).Results2629 level I and 1277 level II patients were included. Early blood product transfusion was significantly higher, pharmacological VTE prophylaxis significantly lower and ICU length of stay significantly longer in level II centers (p < 0.001). On multivariate analysis, treatment at level II centers was independently associated with increased overall complications, specifically ARDS, but not mortality.ConclusionsIn isolated severe pelvic fractures there was a significantly higher use of early blood products, less VTE pharmacological prophylaxis, longer ICU length of stay and higher overall complications and ARDS in level II centers. Blood product utilization and pharmacological VTE prophylaxis are potential areas of quality improvement in level II centers. The aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified trauma centers. ACS-TQIP database study, including patients with blunt, isolated severe pelvic facture (AIS 3–5). 2629 level I and 1277 level II patients were included. Early blood product transfusion was significantly higher, pharmacological VTE prophylaxis significantly lower and ICU length of stay significantly longer in level II centers (p < 0.001). On multivariate analysis, treatment at level II centers was independently associated with increased overall complications, specifically ARDS, but not mortality. In isolated severe pelvic fractures there was a significantly higher use of early blood products, less VTE pharmacological prophylaxis, longer ICU length of stay and higher overall complications and ARDS in level II centers. Blood product utilization and pharmacological VTE prophylaxis are potential areas of quality improvement in level II centers. •Higher overall complications in level II centers in isolated severe pelvic fractures.•Significantly higher use of early blood product in level II centers.•More consequent use of LMWH as VTE prophylaxis in level I centers.•Blood product use and VTE prophylaxis as potential areas of quality improvement in level II centers. |
Author | Cremonini, Camilla Benjamin, Elizabeth R. Demetriades, Demetrios Jakob, Dominik A. |
Author_xml | – sequence: 1 givenname: Dominik A. surname: Jakob fullname: Jakob, Dominik A. email: Dominik.a.jakob@gmail.com – sequence: 2 givenname: Elizabeth R. surname: Benjamin fullname: Benjamin, Elizabeth R. email: Erbenjamin1@gmail.com – sequence: 3 givenname: Camilla orcidid: 0000-0003-1503-7087 surname: Cremonini fullname: Cremonini, Camilla email: C.cremonini89@gmail.com – sequence: 4 givenname: Demetrios surname: Demetriades fullname: Demetriades, Demetrios email: Demetrios.Demetriades@med.usc.edu |
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Snippet | The aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified trauma centers.... BackgroundThe aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified... BACKGROUNDThe aim of this study was to evaluate the management strategies and outcomes of isolated severe pelvic fractures in level I and II ACS verified... |
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SubjectTerms | Angiography Blood products Blood transfusion Cardiac arrhythmia Complications Disease prevention Facility level Fractures Hospitals Hypotension Injuries Intensive care Laparotomy Medical imaging Mortality Multivariate analysis Outcome Patients Pelvic fracture Pharmacology Pneumonia Prophylaxis Quality control Thromboembolism Transfusion Trauma Trauma centers |
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Title | Management and outcomes of severe pelvic fractures in level I and II ACS verified trauma centers |
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