DEATH FROM PELVIC FRACTURE - CHILDREN ARE DIFFERENT

This study compares outcome from pelvic fractures in children with tha t of adults. Data for 23,700 children registered in the National Pedia tric Trauma Registry (NPTR) were compared with those of 10,720 adults recorded over 5 years in the registry of our level I trauma center. Pa tients were categorized by open versus closed fracture and by fracture type as defined by a modification of the Key and Conwell system. Outc ome was evaluated by mortality rate and incidence of fracture induced fatal exsanguination. The 722 pelvic fractures recorded in the NPTR re present 3% of the population and is half the frequency represented by the 532 adults evaluated (P < .001). The overall mortality rate was 5% for children and 17% for adults. Two children died of fracture-relate d exsanguination; there were 18 such deaths among the adults. Pelvic r ing disruption was encountered more commonly among adults, and was ass ociated with a significantly higher mortality rate. Patients with init ial hemodynamic instability were more likely to die, although children less so than adults. The authors conclude that children do not die of pelvic fracture-associated hemorrhage as often as adults. Massive blo od loss in the child occurs most commonly from solid visceral injury r ather than from pelvic vascular disruption. Copyright (C) 1996 by W.B. Saunders Company