Top

Clinical Orthopaedics and Related Research®

Published in:

01-09-2013 | Symposium: Tscherne Festschrift

What Are Predictors for Patients’ Quality of Life After Pelvic Ring Fractures?

Authors: Joerg H. Holstein, MD, Antonius Pizanis, MD, Daniel Köhler, MD, Tim Pohlemann, MD, Working Group Quality of Life After Pelvic Fractures

Published in: Clinical Orthopaedics and Related Research® | Issue 9/2013

Abstract

Background

Data from literature on predictors for patients’ quality of life after pelvic ring fractures are conflicting and based on small study populations.

Questions/purposes

We therefore evaluated predictors for health-related quality of life in patients with pelvic ring injuries at a minimum of 1 year postfracture.

Methods

We surveyed 172 patients of the German Pelvic Trauma Registry admitted to four medical centers between February 3, 2004, and May 11, 2011. The median age of the followup cohort was 47 years (range, 8–88 years); 69 of 172 (40%) patients were female. Patients were characterized by a median Injury Severity Score of 17. There were 31 Tile Type A fractures (18%), 77 Type B fractures (45%), and 64 Type C fractures (37%). The incidence of complex fractures and multiple traumas was 34 of 172 (20%) and 116 of 172 (67%), respectively. One hundred twenty-five (73%) patients were treated operatively. We obtained the EQ-5D™ score to assess patients’ health-related quality of life. For the analysis of predictors for quality of life, a multivariate linear regression model was built. The median followup was 3 years (range, 1–6 years).

Results

The median EQ-5D™ score was 0.78 (interquartile limits, 0.63 and 1.00). Age, complex trauma, and surgery independently predicted the EQ-5D™ score.

Conclusions

We conclude patients with higher age, complex trauma, and surgery had a higher likelihood for a reduced quality of life after pelvic ring injuries.

Level of Evidence

Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Aprahamian C, Wolferth CC Jr, Darin JC, McMahon J, Weitzel-DeVeas C. Status of trauma center designation. J Trauma. 1989;29:566–570.PubMedCrossRef

Ayvaz M, Caglar O, Yilmaz G, Guvendik GI, Acaroglu RE. Long-term outcome and quality of life of patients with unstable pelvic fractures treated by closed reduction and percutaneous fixation. Ulus Travma Acil Cerrahi Derg. 2011;17:261–266.PubMed

Baker SP, O’Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187–196.PubMedCrossRef

Culemann U, Scola A, Tosounidis G, Pohlemann T, Gebhard F. [Concept for treatment of pelvic ring injuries in elderly patients: a challenge] [in German]. Unfallchirurg. 2010;113:258–271.PubMedCrossRef

Draijer F, Egbers HJ, Havemann D, Zimmermann M. [Results of follow-up of conservatively and surgically treated injuries of the pelvic ring within the scope of a prospective study] [in German]. Unfallchirurg. 1995;98:355–360.PubMed

Eid K, Keel M, Keller A, Ertel W, Trentz O. [Influence of sacral fracture on the long-term outcome of pelvic ring injuries] [in German]. Unfallchirurg. 2005;108:35–36, 38–42.

EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy. 1990;16:199–208.

Gebhard F, Culemann U. [Pelvic ring injuries in the elderly] [in German]. Unfallchirurg. 2010;113:257.PubMedCrossRef

Hauschild O, Aghayev E, von Heyden J, Strohm PC, Culemann U, Pohlemann T, Suedkamp NP, Schmal H. Angioembolization for pelvic hemorrhage control: results from the German Pelvic Injury Register. J Trauma Acute Care Surg. 2012;73:679–684.PubMedCrossRef

10.

Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM. Pelvic fracture in geriatric patients: a distinct clinical entity. J Trauma. 2002;53:15–20.PubMedCrossRef

11.

Holstein JH, Culemann U, Pohlemann T; Working Group Mortality in Pelvic Fracture Patients. What are predictors of mortality in patients with pelvic fractures? Clin Orthop Relat Res. 2012;470:2090–2097.PubMedCrossRef

12.

Kabak S, Halici M, Tuncel M, Avsarogullari L, Baktir A, Basturk M. Functional outcome of open reduction and internal fixation for completely unstable pelvic ring fractures (type C): a report of 40 cases. J Orthop Trauma. 2003;17:555–562.PubMedCrossRef

13.

Kannus P, Palvanen M, Niemi S, Parkkari J, Jarvinen M. Epidemiology of osteoporotic pelvic fractures in elderly people in Finland: sharp increase in 1970–1997 and alarming projections for the new millennium. Osteoporos Int. 2000;11:443–448.PubMedCrossRef

14.

Keeter S, Kennedy C, Dimock M, Best J, Craighill P. Gauging the impact of growing nonresponse on estimates from a National RDD Telephone Survey. Public Opin Q. 2006;70:759–779.CrossRef

15.

Kind P, Hardman G, Macran S. UK Population Norms for EQ-5D. York, UK: Centre for Health Economics, University of York; 1999.

16.

Morris RO, Sonibare A, Green DJ, Masud T. Closed pelvic fractures: characteristics and outcomes in older patients admitted to medical and geriatric wards. Postgrad Med J. 2000;76:646–650.PubMedCrossRef

17.

O’Brien D P, Luchette FA, Pereira SJ, Lim E, Seeskin CS, James L, Miller S, Davis K Jr, Hurst JM, Johannigman JA, Frame SB. Pelvic fracture in the elderly is associated with increased mortality. Surgery. 2002;132:710–714; discussion 714–715.

18.

Pohlemann T, Gansslen A, Schellwald O, Culemann U, Tscherne H. Outcome after pelvic ring injuries. Injury. 1996;27(suppl 2):B31–B38.PubMed

19.

Pohlemann T, Tosounidis G, Bircher M, Giannoudis P, Culemann U. The German Multicentre Pelvis Registry: a template for an European Expert Network? Injury. 2007;38:416–423.PubMedCrossRef

20.

Pohlemann T, Tscherne H, Baumgartel F, Egbers HJ, Euler E, Maurer F, Fell M, Mayr E, Quirini WW, Schlickewei W, Weinberg A. [Pelvic fractures: epidemiology, therapy and long-term outcome: overview of the multicenter study of the Pelvis Study Group] [in German]. Unfallchirurg. 1996;99:160–167.PubMedCrossRef

21.

Poole GV, Ward EF, Muakkassa FF, Hsu HS, Griswold JA, Rhodes RS. Pelvic fracture from major blunt trauma: outcome is determined by associated injuries. Ann Surg. 1991;213:532–538; discussion 538–539.

22.

Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001;33:337–343.PubMedCrossRef

23.

Siebert H. [White book of severely injured—care of the DGU: recommendations on structure, organization and provision of hospital equipment for care of severely injured in the Federal Republic of Germany] [in German]. Unfallchirurg. 2006;109:815–820.PubMedCrossRef

24.

Suzuki T, Shindo M, Soma K, Minehara H, Nakamura K, Uchino M, Itoman M. Long-term functional outcome after unstable pelvic ring fracture. J Trauma. 2007;63:884–888.PubMedCrossRef

25.

Tile M. Acute pelvic fractures: I. Causation and classification. J Am Acad Orthop Surg. 1996;4:143–151.PubMed

26.

Tosounidis G, Culemann U, Stengel D, Garcia P, Kurowski R, Holstein JH, Pohlemann T. [Complex pelvic trauma in elderly patients] [in German]. Unfallchirurg. 2010;113:281–286.PubMedCrossRef

27.

Tosounidis G, Holstein JH, Culemann U, Holmenschlager F, Stuby F, Pohlemann T. Changes in epidemiology and treatment of pelvic ring fractures in Germany: an analysis on data of German Pelvic Multicenter Study Groups I and III (DGU/AO). Acta Chir Orthop Traumatol Cech. 2010;77:450–456.PubMed

28.

Visser PS, Krosnick JA, Marquette J, Curtin M. Mail surveys for election forecasting? An evaluation of the Colombia Dispatch Poll. Public Opin Q. 1996;60:181–227.CrossRef

29.

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–1457.CrossRef

Title: What Are Predictors for Patients’ Quality of Life After Pelvic Ring Fractures?
Authors: Joerg H. Holstein, MD
Antonius Pizanis, MD
Daniel Köhler, MD
Tim Pohlemann, MD
Working Group Quality of Life After Pelvic Fractures
Publication date: 01-09-2013
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 9/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-2840-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

What Are Predictors for Patients’ Quality of Life After Pelvic Ring Fractures?

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Please log in to get access to this content

Other articles of this Issue 9/2013

Heterotopic Ossification Rates After Acetabular Fracture Surgery Are Unchanged Without Indomethacin Prophylaxis

Is There an Epidemic Vitamin D Deficiency in German Orthopaedic Patients?

The Peripheral Neuronal Phenotype is Important in the Pathogenesis of Painful Human Tendinopathy: A Systematic Review

CORR Insights®: Is Premorbid Glenoid Anatomy Altered in Patients with Glenohumeral Osteoarthritis?

Case Report: Thoracic Outlet Syndrome in an Elite Archer in Full-draw Position

High Prevalence of Adverse Reactions to Metal Debris in Small-headed ASR™ Hips