Evidence map›Paper›PMID 38478055›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

Clinically relevant bleeding risk in low-energy fragility fractures of the pelvis in elderly patients.

Charissa L de Herdt, Sverre A I Loggers, Daphne van Embden, Taco Bijlsma, Pieter Joosse, Kees-Jan Ponsen

Erratum issuedOpen access · greenAbstract read
PubMed Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.4field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

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  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Charissa L de HerdtDepartment of Surgery, Northwest Clinics Alkmaar, Wilheminalaan 12, P.O Box 501, 1800 AM, Alkmaar, The Netherlands.
Sverre A I LoggersDepartment of Surgery, Northwest Clinics Alkmaar, Wilheminalaan 12, P.O Box 501, 1800 AM, Alkmaar, The Netherlands. s.loggers@nwz.nl.ORCID http://orcid.org/0000-0003-3891-7124
Daphne van EmbdenDepartment of Surgery, Amsterdam UMC Location AMC, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
Taco BijlsmaDepartment of Surgery, Northwest Clinics Alkmaar, Wilheminalaan 12, P.O Box 501, 1800 AM, Alkmaar, The Netherlands.
Pieter JoosseDepartment of Surgery, Northwest Clinics Alkmaar, Wilheminalaan 12, P.O Box 501, 1800 AM, Alkmaar, The Netherlands.
Kees-Jan PonsenDepartment of Surgery, Northwest Clinics Alkmaar, Wilheminalaan 12, P.O Box 501, 1800 AM, Alkmaar, The Netherlands.
Amsterdam University Medical Centers · NLNorthwest Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLow-energy fragility fractures of the pelvis (FFP) are an underestimated entity, yet increasing in incidence. The bleeding risk for pelvic fractures in high-energy trauma is well known, resulting in adequate treatment guidelines and clear protocols. This is not the case for FFPs but this risk is presumably low. This study aims to investigate the clinically relevant bleeding risk, in patients older than 50 years with a fragility fracture of the pelvis admitted to the emergency department (ED).

methodA retrospective cohort study was conducted of consecutive patients aged over 50 years with a FFP due to low-energy trauma (LET) presented to the ED of a single trauma center (North-West Clinics in Alkmaar, The Netherlands) between January 2018 and August 2022. The primary outcome was the percentage of patients requiring blood transfusion, or invasive procedures such as coiling by the interventional radiologists or damage control surgery, due to bleeding. Secondary outcomes were the mean decrease of hemoglobin and mortality.

resultsIn total, 322 consecutive patients with a mean age of 80 years of which 84% female were included. In total 66% was admitted to the hospital and seven patients underwent surgical intervention. Three cases (0.9%) of potentially clinically relevant bleeding were observed. These three cases needed a blood transfusion, without other interventions, and were all admitted with a low hemoglobin level without signs of hemodynamic instability. No invasive interventions were noted.

conclusionThe risk of bleeding in FFP's is very low with very few patients requiring blood transfusions (< 1%) and with no invasive interventions due to bleeding. Since the risk of clinically relevant bleeding is low, the significance of repeated Hb checks and CECT may be questionable. The effect of these diagnostics in case of absence of hemodynamic instability and above borderline normal Hb levels needs to be investigated in further studies.

Indexed as

Blood TransfusionHemorrhagePelvic BonesAgedAged, 80 and overEmergency Service, HospitalFemaleFractures, BoneHumansMaleMiddle AgedNetherlandsRetrospective StudiesRisk FactorsTrauma CentersCT imagingFragility fractureInsufficiency fracturePelvic fractureSacral fracture

Identifiers

PMID38478055
OpenAlexW4392747718

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.