Article Abstract

Blood loss in pelvic ring fractures: CT-based estimation

Authors: Nils T. Veith, Moritz Klein, Daniel Köhler, Thomas Tschernig, Jörg Holstein, Philipp Mörsdorf, Tim Pohlemann, Benedikt J. Braun


Background: The main cause of mortality after pelvic ring fractures is the acute haemorrhagic shock. The aim of the study was to estimate blood loss using CT and to correlate estimated blood loss to the mortality.
Methods: A retrospective analysis of 42 patients with AO/OTA C-type pelvic ring fractures was performed. In total 29 AO/OTA C1-type, 4 C2-type and 9 C3-type fractures were analysed. A CT-volumetric analysis was developed to estimate the early blood loss in the different compartments. The results were correlated to the mortality of the patients.
Results: Significant increases in interstitial free blood volume (392±502.8 vs. 888±663; P<0.05) and total blood loss (476±535 vs. 1,005±649; P<0.05) were seen when comparing C1 to C3-type fractures. Early blood loss significantly correlated to mortality. No significant difference was seen between all groups with respect to systolic blood pressure, haemoglobin concentration and the Injury Severity Score (ISS).
Conclusions: In pelvic ring fractures the CT-estimated blood loss correlates to mortality.