{"id":4570,"date":"2018-07-06T00:00:00","date_gmt":"2018-07-06T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/"},"modified":"2023-06-14T19:25:04","modified_gmt":"2023-06-14T23:25:04","slug":"high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/","title":{"rendered":"High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada"},"content":{"rendered":"<p><strong>Introduction<\/strong> &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients with high-energy polytrauma. High-energy pelvic fractures are life-threatening injuries, with mortality estimates ranging from 6 to 35%. The purpose of this study was to examine trends in the incidence, diagnosis, treatment, and mortality rates of high-energy pelvic fractures in Ontario, Canada over a 10-year period.<\/p>\n<p><strong>Methods <\/strong>&#x2014; A cohort of 3915 patients who sustained a high-energy pelvic fracture in Ontario between 01 April 2005 and 31 March 2015 was identified using the Ontario Trauma Registry and administrative healthcare data linked by the Institute for Clinical Evaluative Science (ICES). Severely injured patients (defined as having an Injury Severity Score (ISS) of &gt;\/=16) with pelvic fractures following high-velocity mechanisms of injury were identified using applicable ICD-10 codes. Trends were assessed statistically using the Poisson and the Cochrane-Armitage tests for trend. Modified Poisson regression was used to model the adjusted risk ratio of mortality by pelvic fracture treatment.<\/p>\n<p><strong>Results <\/strong>&#x2014; The incidence of pelvic fracture remained constant at approximately 4.6 cases per 100,000 population annually between 2005 and 2011. From 2012, there was a decrease in patients with ISS&gt;\/=16 due to changes in the calculation of the ISS. The proportion of patients presenting with ISS&gt;50 increased from 8.2% to 14.1% (p=0.008) over the study period. Automobile collisions or pedestrians struck by vehicles accounted for over half of injuries. Approximately 6% of patients underwent angioembolisation. Treatment with external fixation (15.5%-20.2%) or no surgical intervention (46.2%-61.3%) increased from 2005 to 2015. Mortality remained constant (11% at 30 days), and laparotomy was the only major intervention not associated with decreased risk of death.<\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Stable mortality despite increasing injury severity suggests that the quality of care provided to patients with high-energy pelvic fractures has improved over time. However, unchanged incidence suggests the need for ongoing efforts aimed towards injury prevention. ISS at presentation was the most significant predictor of mortality in this patient population.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients with high-energy polytrauma. High-energy pelvic fractures are life-threatening injuries, with mortality estimates ranging from 6 to 35%. The purpose of this study was to examine trends in the incidence, diagnosis, treatment, and [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-4570","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Mann SM, Banaszek D, Lajkosz K, Brogly SB, Stanojev SM, Evans C, Bardana DD, Yach J, Hall S. <em>Injury<\/em>. 2018; 49(10):1830-40. Epub 2018 Jul 6.","source_url":"","ices_scientist":[1168,1222],"site":[6736],"research_program":[6741],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"60C7D891-1F1D-40FB-9BFD-1F6A7F23AED8","sitecore_item_name":"High-energy-trauma-patients-with-pelvic-fractures-management-trends-in-Ontario-Canada","sitecore_field_values":"{\n  \"Title\": \"High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada\",\n  \"Short title\": \"High-energy trauma patients with\",\n  \"Summary\": \"The purpose of this study was to examine trends in the incidence, diagnosis, treatment, and mortality rates of high-energy pelvic fractures in Ontario, Canada over a 10-year period. \",\n  \"Citation\": \"<p>Mann SM, Banaszek D, Lajkosz K, Brogly SB, Stanojev SM, Evans C, Bardana DD, Yach J, Hall S. <em>Injury<\/em>. 2018; 49(10):1830-40. Epub 2018 Jul 6.<\/p>\",\n  \"Abstract\": \"<p><strong>Introduction<\/strong> &mdash; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients with high-energy polytrauma. High-energy pelvic fractures are life-threatening injuries, with mortality estimates ranging from 6 to 35%. The purpose of this study was to examine trends in the incidence, diagnosis, treatment, and mortality rates of high-energy pelvic fractures in Ontario, Canada over a 10-year period.<\/p>n<p><strong>Methods <\/strong>&mdash; A cohort of 3915 patients who sustained a high-energy pelvic fracture in Ontario between 01 April 2005 and 31 March 2015 was identified using the Ontario Trauma Registry and administrative healthcare data linked by the Institute for Clinical Evaluative Science (ICES). Severely injured patients (defined as having an Injury Severity Score (ISS) of &gt;\/=16) with pelvic fractures following high-velocity mechanisms of injury were identified using applicable ICD-10 codes. Trends were assessed statistically using the Poisson and the Cochrane-Armitage tests for trend. Modified Poisson regression was used to model the adjusted risk ratio of mortality by pelvic fracture treatment.<\/p>n<p><strong>Results <\/strong>&mdash; The incidence of pelvic fracture remained constant at approximately 4.6 cases per 100,000 population annually between 2005 and 2011. From 2012, there was a decrease in patients with ISS&gt;\/=16 due to changes in the calculation of the ISS. The proportion of patients presenting with ISS&gt;50 increased from 8.2% to 14.1% (p=0.008) over the study period. Automobile collisions or pedestrians struck by vehicles accounted for over half of injuries. Approximately 6% of patients underwent angioembolisation. Treatment with external fixation (15.5%-20.2%) or no surgical intervention (46.2%-61.3%) increased from 2005 to 2015. Mortality remained constant (11% at 30 days), and laparotomy was the only major intervention not associated with decreased risk of death.<\/p>n<p><strong>Conclusions<\/strong> &mdash; Stable mortality despite increasing injury severity suggests that the quality of care provided to patients with high-energy pelvic fractures has improved over time. However, unchanged incidence suggests the need for ongoing efforts aimed towards injury prevention. ISS at presentation was the most significant predictor of mortality in this patient population.<\/p>\",\n  \"Research Programs\": \"{85DE96A6-4C96-40C7-8E6D-7597A0EB5F80}\",\n  \"ICES Locations\": \"{5A12C65D-3CDA-413E-BC94-C1D778156CE6}\",\n  \"ICES Scientists\": \"{64579365-C01D-4F5C-81E8-7A5ECC8B20D3}|{2450C4C5-A5C3-4FFF-B28D-644072C941C5}|{1256A696-C916-40AC-BA25-28FEFC266D6C}\",\n  \"Posted Date\": \"20180706T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2018\/July\/High-energy-trauma-patients-with-pelvic-fractures-management-trends-in-Ontario-Canada"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada<\/title>\n<meta name=\"description\" content=\"Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada\" \/>\n<meta property=\"og:description\" content=\"Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:25:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\\\/\",\"name\":\"ICES | High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2018-07-06T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:25:04+00:00\",\"description\":\"Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Journal Articles\",\"item\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"name\":\"ICES\",\"description\":\"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\"},\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#organization\",\"name\":\"ICES\",\"alternateName\":\"Institute for Clinical Evaluative Sciences\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"contentUrl\":\"https:\\\/\\\/www.ices.on.ca\\\/wp-content\\\/uploads\\\/2023\\\/04\\\/ices-logo.png\",\"width\":\"676\",\"height\":\"618\",\"caption\":\"ICES\"},\"image\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/ICESOntario\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/ices-research-institute\\\/\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"ICES | High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada","description":"Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/","og_locale":"fr_FR","og_type":"article","og_title":"ICES | High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada","og_description":"Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients","og_url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/","og_site_name":"ICES","article_publisher":"https:\/\/www.facebook.com\/ICESOntario\/","article_modified_time":"2023-06-14T23:25:04+00:00","og_image":[{"width":1200,"height":675,"url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/","url":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/","name":"ICES | High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada","isPartOf":{"@id":"https:\/\/www.ices.on.ca\/fr\/#website"},"datePublished":"2018-07-06T04:00:00+00:00","dateModified":"2023-06-14T23:25:04+00:00","description":"Introduction &#x2014; Although fractures of the pelvic ring account for only 2-3% of all fractures, they are present in approximately 7-20% of patients","breadcrumb":{"@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/high-energy-trauma-patients-with-pelvic-fractures-management-trends-in-ontario-canada\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.ices.on.ca\/fr\/"},{"@type":"ListItem","position":2,"name":"Journal Articles","item":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/"},{"@type":"ListItem","position":3,"name":"High-energy trauma patients with pelvic fractures: management trends in Ontario, Canada"}]},{"@type":"WebSite","@id":"https:\/\/www.ices.on.ca\/fr\/#website","url":"https:\/\/www.ices.on.ca\/fr\/","name":"ICES","description":"POPULATION-BASED HEALTH RESEARCH THAT MAKES A DIFFERENCE","publisher":{"@id":"https:\/\/www.ices.on.ca\/fr\/#organization"},"alternateName":"Institute for Clinical Evaluative Sciences","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.ices.on.ca\/fr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/www.ices.on.ca\/fr\/#organization","name":"ICES","alternateName":"Institute for Clinical Evaluative Sciences","url":"https:\/\/www.ices.on.ca\/fr\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/","url":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","contentUrl":"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2023\/04\/ices-logo.png","width":"676","height":"618","caption":"ICES"},"image":{"@id":"https:\/\/www.ices.on.ca\/fr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ICESOntario\/","https:\/\/www.linkedin.com\/company\/ices-research-institute\/"]}]}},"_links":{"self":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article\/4570","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/journal_article"}],"about":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/types\/journal_article"}],"acf:post":[{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/research_program\/6741"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/site\/6736"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1222"},{"embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/ices_scientist\/1168"}],"wp:attachment":[{"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/media?parent=4570"}],"wp:term":[{"taxonomy":"migration-helper-automated","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-automated?post=4570"},{"taxonomy":"migration-manual","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-manual?post=4570"},{"taxonomy":"topic","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/topic?post=4570"},{"taxonomy":"migration-helper-qa-sample-set","embeddable":true,"href":"https:\/\/www.ices.on.ca\/fr\/wp-json\/wp\/v2\/migration-helper-qa-sample-set?post=4570"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}