https://nova.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 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 ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:21435 4 hours after injury or dead on arrival were excluded. Patient management followed advanced trauma life support and institutional guidelines. Collected data included patient demographics, mechanism of injury, vital signs, acid-base status, fluid resuscitation, trauma scores, fracture patterns, procedures, and outcomes. Potential predictors were identified using standard statistical tests: Univariate analysis, Pearson correlation (r), receiver operator characteristic, and decision tree analysis. Intervention: Observational study. Outcome Measures: PFRAB was determined based on angiography or computed tomography angiogram or laparotomy findings. Results: Of the 143 study patients, 15 (10%) had PFRAB. They were significantly older, more severely injured, more hypotensive, more acidotic, more likely to require transfusions in the ED, and had higher mortality rate than non-PFRAB patients. No single variable proved to be a strong predictor but some had a significant correlation with PFRAB. Useful predictors identified were worst base deficit (BD), receiver operator characteristic (0.77, cutoff: 6 mmol/L, r = 0.37), difference between any 2 measures of BD within 4 hours (ΔBD) >2 mmol/L, transfusion in ED (yes/no), and worst systolic blood pressure <104 mm Hg. Demographics, injury mechanism, fracture pattern, temperature, and pH had poor predictive value. Conclusions: BD <6 mmol/L, ΔBD >2 mmol/L, systolic blood pressure <104 mm Hg, and the need for transfusion in ED are independent predictors of PFRAB in the ED. These predictors can be valuable to triage blunt trauma victims for pelvic hemorrhage control with angiography.]]> Sat 24 Mar 2018 08:05:47 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:18143 Sat 24 Mar 2018 08:04:45 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19238 Sat 24 Mar 2018 07:54:55 AEDT ]]>