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J Trauma Inj > Volume 29(4); 2016 > Article
Journal of Trauma and Injury 2016;29(4):139-145.
DOI: https://doi.org/10.20408/jti.2016.29.4.139    Published online December 31, 2016.
The Effect of Trauma Team Approach on the Management of Hemodynamically Unstable Pelvic Bone Fracture: Retrospective Comparative study
Won Tae Cho, Jae Woo Cho, Jinil Kim, Jin Kak Kim, Jong Keon Oh, Hak Jun Kim, Namryeol Kim, Jun Min Cho
1Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea.
2Department of General Surgery, Korea University Guro Hospital, Seoul, Korea. nobleedings@gmail.com
Received: 14 October 2016   • Revised: 28 November 2016   • Accepted: 7 December 2016
Abstract
PURPOSE
The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture.
METHODS
This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity.
RESULTS
Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, 63.09±50.48 vs 21.48±17.75; p=0.038) and total length of stay in the ED (min, 269.33±105.96 vs 115.49±56.24; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results.
CONCLUSION
The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.
Key Words: Pelvis; Trauma; Fracture


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