Updated concepts on the pathophysiology and the clinical management of trauma hemorrhage and coagulopathy.

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Abstract

[Indexed for MEDLINE] 19. Prehosp Emerg Care. 2024;28(4):589-597. doi: 10.1080/10903127.2024.2322014. Epub 2024 Mar 18. Hemorrhagic Shock in Isolated and Non-Isolated Pelvic Fractures: A Registries-Based Study. Gottfried A(1), Gendler S(1), Chayen D(1)(2), Radomislensky I(1)(3), Mitchnik IY(1)(2)(4); Israel Trauma Group; Epshtein E(1), Tsur AM(1)(2)(5)(6), Almog O(1)(2), Talmy T(1)(2)(7). Author information: (1)Israel Defense Forces Medical Corps, Surgeon's General Headquarters, Ramat Gan, Israel. (2)Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel. (3)The National Center for Trauma and Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-HaShomer, Israel. (4)Department of Orthopedic Surgery, Shamir Medical Center, Zrifin, Israel. (5)Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel. (6)Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. (7)Division of Anesthesia, Intensive Care, and Pain, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel. BACKGROUND: Pelvic fractures resulting from high-energy trauma can frequently present with life-threatening hemodynamic instability that is associated with high mortality rates. The role of pelvic exsanguination in causing hemorrhagic shock is unclear, as associated injuries frequently accompany pelvic fractures. This study aims to compare the incidence of hemorrhagic shock and in-hospital outcomes in patients with isolated and non-isolated pelvic fractures. METHODS: Registries-based study of trauma patients hospitalized following pelvic fractures. Data from 1997 to 2021 were cross-referenced between the Israel Defense Forces Trauma Registry (IDF-TR), documenting prehospital care, and Israel National Trauma Registry (INTR) recording hospitalization data. Patients with isolated pelvic fractures were defined as having an Abbreviated Injury Scale (AIS)