دورية أكاديمية
أعرض في EDS

Identification and Management of Pelvic Fractures in Prehospital and Emergency Department Settings.

التفاصيل البيبلوغرافية
العنوان: Identification and Management of Pelvic Fractures in Prehospital and Emergency Department Settings.
المؤلفون: Coulombe P; VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, Canada., Malo C; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de Recherche en Traumatologie - Urgences - Soins Intensifs, Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada., Robitaille-Fortin M; Coopérative des Techniciens Ambulanciers de Québec (CTAQ), Québec, QC, Canada., Nadeau A; VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de Recherche en Traumatologie - Urgences - Soins Intensifs, Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada., Émond M; VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de Recherche en Traumatologie - Urgences - Soins Intensifs, Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada., Moore L; Département de Médecine Préventive, Faculté de Médecine, Université Laval, Québec, QC, Canada., Blanchard PG; VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de Recherche en Traumatologie - Urgences - Soins Intensifs, Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada., Benhamed A; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de Recherche en Traumatologie - Urgences - Soins Intensifs, Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada., Mercier E; VITAM - Centre de Recherche en Santé Durable de l'Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de Recherche en Traumatologie - Urgences - Soins Intensifs, Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada. Electronic address: eric.mercier@fmed.ulaval.ca.
المصدر: The Journal of surgical research [J Surg Res] 2024 Aug; Vol. 300, pp. 371-380. Date of Electronic Publication: 2024 Jun 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
مواضيع طبية MeSH: Pelvic Bones*/injuries , Fractures, Bone*/therapy , Emergency Service, Hospital*/statistics & numerical data , Emergency Medical Services*/statistics & numerical data, Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Aged ; Triage/statistics & numerical data ; Triage/methods ; Trauma Centers/statistics & numerical data ; Quebec/epidemiology ; Young Adult
مستخلص: Introduction: This study aims to describe the characteristics of patients with a pelvic fracture treated at a level 1 trauma center, the proportion of prehospital undertriage and the use of pelvic circumferential compression device (PCCD).
Methods: This is a retrospective cohort study. Prehospital and inhospital medical records of adults (≥16 y old) with a pelvic fracture who were treated at Hopital de l'Enfant-Jesus-CHU de Québec (Quebec City, Canada), a university-affiliated level 1 trauma center, between September 01, 2017 and September 01, 2021 were reviewed. Isolated hip or pubic ramus fracture were excluded. Data are presented using proportions and means with standard deviations.
Results: A total of 228 patients were included (males: 62.3%; mean age: 54.6 [standard deviation 21.1]). Motor vehicle collision (47.4%) was the main mechanism of injury followed by high-level fall (21.5%). Approximately a third (34.2%) needed at least one blood transfusion. Compared to those admitted directly, transferred patients were more likely to be male (73.0% versus 51.3%, P < 0.001) and to have a surgical procedure performed at the trauma center (71.3% versus 46.9%, P < 0.001). The proportion of prehospital undertriage was 22.6%. Overall, 17.1% had an open-book fracture and would have potentially benefited from a prehospital PCCD. Forty-six transferred patients had a PCCD applied at the referral hospital of which 26.1% needed adjustment.
Conclusions: Pelvic fractures are challenging to identify in the prehospital environment and are associated with a high undertriage of 22.6%. Reducing undertriage and optimizing the use of PCCD are key opportunities to improve care of patients with a pelvic fracture.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Emergency; Fracture; Injuries; Pelvic; Prehospital; Trauma
تواريخ الأحداث: Date Created: 20240606 Date Completed: 20240714 Latest Revision: 20240714
رمز التحديث: 20240715
DOI: 10.1016/j.jss.2024.05.006
PMID: 38843724
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-8673
DOI:10.1016/j.jss.2024.05.006