PMID- 34152927
OWN - NLM
STAT- MEDLINE
DCOM- 20220701
LR  - 20220707
IS  - 1545-0066 (Electronic)
IS  - 1090-3127 (Linking)
VI  - 26
IP  - 4
DP  - 2022 Jul-Aug
TI  - Evaluation of Pelvic Circular Compression Devices in Severely Injured Trauma 
      Patients with Pelvic Fractures.
PG  - 547-555
LID - 10.1080/10903127.2021.1945717 [doi]
AB  - Background: The role of pelvic circumferential compression devices (PCCD) is to 
      temporarily stabilize the pelvic ring, reduce its volume and to tamponade 
      bleeding. The purpose of this study was to evaluate the effect of PCCDs on 
      mortality and bleeding in severely injured trauma patients, using a large 
      registry database.Methods: We performed a retrospective analysis of all patients 
      registered in the Trauma Register DGU(R) between 2015 and 2016. The study was 
      limited to directly admitted patients who were alive on admission, with an injury 
      severity score (ISS) of 9 or higher, with an Abbreviated Injury Scale AIS(pelvis) 
      of 3-5, aged at least 16, and with complete status documentation on pelvic 
      circular compression devices (PCCD) and mortality. A cohort analysis was 
      undertaken of patients suffering from relevant pelvic fractures. Data were 
      collected on mortality and requirements for blood transfusion. The observed 
      outcome was compared with the expected outcome as derived from version II of the 
      Revised Injury Severity Classification (RISC II) and adjusted accordingly. A 
      Standardized Mortality Ratio (SMR) was also calculated.Results: A total of 9,910 
      patients were included. 1,103 of 9,910 patients suffered from a relevant pelvic 
      trauma (AIS(pelvis) = 3-5). Only 41% (454 cases) of these received a PCCD. PCCD 
      application had no significant effect on mortality and did not decrease the need 
      for blood transfusion in the multivariate regression analysis. However, in this 
      cohort, the application of a PCCD is a general indicator for a critical patient 
      with increased mortality (12.0% no PCCD applied vs. 23.2% PCCD applied 
      prehospital vs. 27.1% PCCD applied in the emergency department). The ISS was 
      higher in patients with PCCD (34.12 +/- 16.4 vs. 27.9 +/- 13.8; 
      p < 0.001).Conclusion: PCCD was applied more often in patients with severe pelvic 
      trauma according to ISS and AIS(pelvis) as well with deterioration in circulatory 
      status. PCCDs did not reduce mortality or reduce the need for blood 
      transfusion.Trial registration: TR-DGU ID 2017-003, March 2017; German clinical 
      trial register DRKS00024948.
FAU - Berger-Groch, Josephine
AU  - Berger-Groch J
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
FAU - Rueger, Johannes Maria
AU  - Rueger JM
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
FAU - Czorlich, Patrick
AU  - Czorlich P
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
FAU - Frosch, Karl-Heinz
AU  - Frosch KH
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
FAU - Lefering, Rolf
AU  - Lefering R
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
FAU - Hoffmann, Michael
AU  - Hoffmann M
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
CN  - Trauma Register DGU
AD  - Received April 3, 2021 from Department of Trauma and Orthopedic Surgery, 
      University Medical Center, Hamburg, Germany (JB-G, JMR, K-HF, MH); Department of 
      Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PC); 
      Institute for Research in Operative Medicine (IFOM), University of 
      Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany (RL); 
      Department of Orthopaedic and Trauma Surgery, Asklepios St. Georg, Hamburg, 
      Germany (MH). Revised received June 11, 2021; accepted for publication June 15, 
      2021.
LA  - eng
SI  - DRKS/DRKS00024948
PT  - Journal Article
DEP - 20210720
PL  - England
TA  - Prehosp Emerg Care
JT  - Prehospital emergency care
JID - 9703530
SB  - IM
MH  - *Emergency Medical Services
MH  - *Fractures, Bone/therapy
MH  - Hemorrhage/etiology/therapy
MH  - Humans
MH  - Injury Severity Score
MH  - *Pelvic Bones/injuries
MH  - Pelvis/injuries
MH  - Registries
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Abbreviated Injury Scale of the pelvis
OT  - ISS
OT  - mortality
OT  - pelvic fracture
OT  - polytrauma
OT  - registry
EDAT- 2021/06/22 06:00
MHDA- 2022/07/02 06:00
CRDT- 2021/06/21 17:18
PHST- 2021/06/22 06:00 [pubmed]
PHST- 2022/07/02 06:00 [medline]
PHST- 2021/06/21 17:18 [entrez]
AID - 10.1080/10903127.2021.1945717 [doi]
PST - ppublish
SO  - Prehosp Emerg Care. 2022 Jul-Aug;26(4):547-555. doi: 
      10.1080/10903127.2021.1945717. Epub 2021 Jul 20.