Prognosis of acute pelvic fractures in elderly patients: retrospective study.

Abstract

OBJECTIVE: To analyse the pattern of acute pelvic fractures, prognostic indicators, and intermediate-term functional outcome among elderly patients. DESIGN: Retrospective study. SETTING: Community-based hospital, Hong Kong. PATIENTS: Sixty patients older than 60 years who were admitted to hospital with acute pelvic fracture between 1 November 1993 and 31 December 1996. MAIN OUTCOME MEASURES: Review of medical records and X-ray assessment to determine the patients' demographic data, medical comorbidities, aetiology and mechanism of injury, associated injuries, and clinical outcome indicators such as complications, duration of hospital stay, ambulatory status, and 1- and 2-year mortality rates. RESULTS: The mean follow-up period was 29 months (range, 12 to 65 months). Eighty-seven percent of patients were women and the predominant fracture pattern was Tile A2. The leading cause of injury was low-energy fall injury (75%). The 1-year mortality rate was nearly 12%. Thirty-six percent of patients experienced a decline in ambulatory status. Twenty-five percent of superior rami fractures involved the low anterior column of the acetabulum. There was a high incidence of associated cardiovascular disorders. CONCLUSIONS: Pre-existing medical conditions and acetabular involvement are important adverse factors affecting postinjury ambulatory status. A significant decline in ambulatory status and a significant mortality rate at 1 year were found following pelvic fracture in elderly patients.