# Analysis of risk factors for death during treatment of hemodynamically unstable pelvic fractures

## TL;DR

This study identifies risk factors for death in patients with unstable pelvic fractures, focusing on shock, injury severity, and bleeding.

## Contribution

The study identifies specific clinical indicators as independent risk factors for mortality in hemodynamically unstable pelvic fracture patients.

## Key findings

- Shock index > 2, ISS, SOFA score, and bleeding volume > 2,000 mL are independent risk factors for death.
- SOFA score had the highest area under the ROC curve (0.907), indicating strong predictive power.
- Targeted management of high-risk patients can reduce mortality.

## Abstract

To analyze the risk factors associated with the occurrence of death during the treatment of patients with hemodynamically unstable pelvic fractures.

The present study is a retrospective research design, which selected 136 patients with hemodynamically unstable pelvic fractures admitted to China Resource & WISCO General Hospital from March 2020 to March 2022 as the subjects of the study. They were divided into a survival group (113 cases) and a death group (23 cases) according to whether the patients died during treatment. The general clinical data and laboratory test indexes of the two groups were compared to analyze the risk factors affecting the death of pelvic fracture patients. Receiver operator characteristic (ROC) curves were plotted, and the area under the curve was calculated.

The two groups were significantly different in aspects of age, systolic blood pressure, rapid emergency medicine score, injury severity score (ISS), sequential organ failure assessment (SOFA) score, prothrombin time, activated partial thromboplastin time, and percentages of patients with bleeding volume > 2,000 mL, shock index > 2, and minimum oxygenation index < 200 (P<0.05). Logistic regression analysis suggested that shock index > 2, ISS, SOFA score, and bleeding volume > 2,000 mL were independent risk factors for patient death. ROC analysis showed that the area under the curve for shock index > 2, ISS, SOFA score, and bleeding volume > 2,000 mL was 0.656, 0.732, 0.907, and 0.798, respectively.

Severe shock, increased ISS and SOFA score, and bleeding are independent risk factors for death in patients with hemodynamically unstable pelvic fractures. Implementation of rapid and efficient targeted management during treatment of high-risk patients with these factors is key to reducing their risk of death.