Comparison of mortality between open and closed pelvic bone fractures in Korea using 1:2 propensity score matching: a single-center retrospective study

Jae-Du Yoo, D. Choi, B. Kang
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Abstract

Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6–30 days vs. median 5 days, IQR 2–13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6–30 days vs. median 8 days, IQR 4–19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.
利用 1:2 倾向评分匹配比较韩国开放性骨盆骨折和闭合性骨盆骨折的死亡率:一项单中心回顾性研究
目的:开放性骨盆骨骨折相对罕见,被认为比闭合性骨折更为严重。本研究旨在比较开放性和闭合性严重骨盆骨折的临床疗效。研究方法回顾性分析2016年至2020年间在一家一级创伤中心收治的严重骨盆骨骨折患者(骨盆简易损伤量表评分≥4分)。研究排除了年龄小于 16 岁和病历不完整的患者。研究人员将患者分为开放性骨折组和闭合性骨折组,并比较了1:2倾向评分匹配前后的人口统计学、治疗和临床结果。研究结果在 321 名患者中,开放性骨折组有 24 人,闭合性骨折组有 297 人。开放性骨折组的感染率更高(37.5% 对 5.7%,P<0.001),在重症监护室的住院时间更长(中位数 11 天,四分位数间距 [IQR] 6-30 天,对中位数 5 天,四分位数间距 [IQR] 2-13 天,P=0.005),但死亡率在匹配前没有显著统计学差异(20.8% 对 15.5%,P=0.559)。经过 1:2 倾向评分匹配后,开放性骨折组的感染率明显更高(37.5% vs. 6.3%,P=0.002),而重症监护室住院时间(中位数 11 天,IQR 6-30 天 vs. 中位数 8 天,IQR 4-19 天;P=0.312)和死亡率(20.8% vs. 27.1%,P=0.564)则无明显差异。结论:开放式骨盆骨折组的感染率高于闭合式骨盆骨折组,但死亡率无明显差异。无论骨折类型如何,积极治疗骨盆骨折都很重要,而努力减少感染对开放性骨盆骨折很重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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