 EBL - 4.5 Liters > 0.5 mm post displacement - 6.5 Liters |
 EBL - 1 Liter > 0.5 mm post displacement - 4.5 Liters |
 > 0.5 mm post displacement - 7 Liters |
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TITLE: Pelvic fracture classification: correlation with hemorrhage.
SOURCE: J Trauma 1988 Jul;28(7):973-80
EBL - 4.5 Liters > 0.5 mm post displacement - 6.5 Liters |
EBL - 1 Liter > 0.5 mm post displacement - 4.5 Liters |
> 0.5 mm post displacement - 7 Liters |
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AUTHORS: Cryer HM; Miller FB; Evers BM; Rouben LR; Seligson DL, Department of Surgery, University of Louisville, KY 40292.
ABSTRACT: Hemorrhage remains the leading cause of death in patients with pelvic fractures. To identify patients at greatest risk for massive hemorrhage, we retrospectively reviewed charts and initial emergency room anterior-posterior (AP) radiographs of 245 consecutive patients. Pelvic fractures were classified according to our modification of the Pennel and Sutherland classification scheme. A simple pelvic fracture classification scheme was developed. Using this classification, we can be 90% confident that 50 to 69% of patients with "unstable" pelvic fractures will require 4 or more units of blood, 30 to 49% will require greater than 10 units of blood, 36 to 55% will have an intra-abdominal injury, and 6 to 18% will have a pelvic arterial injury. Therefore we conclude that this pelvic fracture classification based on the initial emergency-room AP X-ray can predict a patient population at high risk for massive hemorrhage for which an aggressive treatment protocol is justified.