https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 Acute definitive internal fixation of pelvic ring fractures in polytrauma patients: a feasible option https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10753 24 hours). Demographics, Injury Severity Score, pelvic Abbreviated Injury Score, first 24-hour transfusions, physiologic parameters, time to operating room (OR), angiography requirement, length of stay (LOS), and mortality were recorded. Data are presented as mean ± SD or percentages. Statistical significance was determined at p < 0.05 based on univariate analysis. Results: Forty-five patients met inclusion criteria, 18 patients had acute definitive ORIF (5.5 hours to OR) and 27 had late definitive ORIF (5 days to OR). Acute and late ORIF patients had comparable demographics (age: 48 ± 22 years vs. 40 ± 14 years, gender: 82% vs. 79% men) and injury severity (Injury Severity Score: 30 ± 18 vs. 24.5 ± 13, pelvic Abbreviated Injury Score: 3.7 ± 1 vs. 3.4 ± 1.1). Initial shock parameters were significantly worse in the acute ORIF group (systolic blood pressure, 69.7 ± 17 mm Hg vs. 108 ± 21 mm Hg; BD, −7.4 ± 4 vs. −4.9 ± 2 mEq/L, lactate 6.67 ± 7 mmol/L vs. 2.51 ± 1.3 mmol/L). Angiography was used in 18% (3/18) vs. 21% (6 of 27) of the cases. All early ORIF patients survived and one (3%) of the late ORIF patients died. There was a trend to shorter hospital LOS (25 ± 24 days vs. 37 ± 32 days) and a decreased 24-hour red cell transfusion rate (4.7 ± 5 U vs. 6.6 ± 4 U) in the early ORIF group. The intensive care unit admission rate (12 of 18 vs. 15 of 27) and LOS was comparable (2.9 ± 2.5 days vs. 3.7 ± 3.6 days). Conclusion: Acute ORIF of unstable pelvic ring fractures within 6 hours could be safely performed even in severely shocked patients with multiple injuries. The procedure did not lead to increased rates of transfusion, mortality, intensive care unit LOS, or overall LOS. Furthermore, all these parameters showed a trend toward benefit compared with a staged approach.]]> Sat 24 Mar 2018 08:08:21 AEDT ]]> Incidence of multiple organ failure in adult polytrauma patients: a systematic review and meta-analysis https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:52615 3, 12.7% (95% CI, 9.3-16.1%) in Denver score >3 with blunt injuries only, 28.6% (95% CI, 12-45.1%) in Denver score >8, 25.6% (95% CI, 10.4-40.7%) in Goris score >4, 29.9% (95% CI, 14.9-45%) in Marshall score >5, 20.3% (95% CI, 9.4-31.2%) in Marshall score >5 with blunt injuries only, 38.6% (95% CI, 33-44.3%) in SOFA score >3, 55.1% (95% CI, 49.7-60.5%) in SOFA score >3 with blunt injuries only, and 34.8% (95% CI, 28.7-40.8%) in SOFA score >5. Conclusion: The incidence of postinjury MOF varies largely because of lack of a consensus definition and study population. Until an international consensus is reached, further research will be hindered. Level of Evidence: Systematic Review and Meta-analysis; Level III.]]> Fri 10 Nov 2023 07:10:04 AEDT ]]>