Pelvic Fractures—An Underestimated Problem? Incidence and Mortality Risk after Pelvic Fracture in Austria, 2010–2018

Abstract

(1) Background: Pelvic fractures (PFs) are related to osteoporosis, and represent a serious individual and socioeconomic burden. (2) Methods: We examined age- and sex-standardised incidence rates (SIRs) of PF, along with rates of all-cause overall and one-year mortality among patients with PF. We compared the mortality rates between PF patients and a matched fracture-free cohort. Patients ≥ 50 years old in Austria hospitalised with PF in 2010–2018, along with their dates of death, were recorded. (3) Results: We identified 54,975 patients with PF, of whom 70.9% were women. Between 2010 and 2018 the SIR of PF increased in men by 10.0%—from 125.3 (95% Confidence Interval 118.9–132.0) to 137.8 (95% CI 131.8–144.0) per 100,000—and in women by 2.7%—from 218.7 (95% CI 212.0–225.6) to 224.7 (95% CI 218.3–231.3) per 100,000. The one-year post-PF mortality rate was higher in men than in women (13.0% and 11.1%, respectively; p < 0.001). Pelvic fracture patients aged ≥ 65 had an elevated mortality risk (Hazard Ratio 1.75, 95% CI 1.71–1.79, p < 0.001) compared to controls. (4) Conclusions: There is a clear increase in the incidence of PF in the elderly population, with a greater increase in men over time. Pelvic fracture itself contributes to increased mortality in individuals aged 65 and above.

Adverse outcomes following pelvic fracture: the critical role of frailty

“…This is particularly worrying considering the elevated risk of adverse outcomes after traumatic insults and subsequent surgical interventions in this patient population [ 7 ]. The mortality rate following low energy pelvic ring fractures can be as high as 27%, comparable to that following hip fracture in geriatric patients [ 5 – 13 ]. Despite the significant disease burden associated with pelvic fractures, they have not been as thoroughly studied in the geriatric population [ 5 , 14 ].…”

“…The mortality rate following low energy pelvic ring fractures can be as high as 27%, comparable to that following hip fracture in geriatric patients [ 5 – 13 ]. Despite the significant disease burden associated with pelvic fractures, they have not been as thoroughly studied in the geriatric population [ 5 , 14 ].…”

“…Geriatric pelvic fracture patients present a heterogeneous patient population with varying prognoses following injury based on fracture pattern and preexisting comorbidities [ 5 , 6 , 8 – 12 ]. One potential avenue for guiding patient care is stratification of patients based on their intrinsic risk of adverse outcomes.…”

Combined Hip Procedure Versus Open Reduction and Internal Fixation for Displaced Acetabular Fractures in Patients Older than 75 years: A Matched Cohort Study

“…With the aging population, we have seen an increasing incidence of these fractures, having more than doubled in recent years. 16,17 Displaced acetabular fractures will continue to present a unique challenge regarding patient and procedure selection considering the elevated mortality risks in the geriatric population 18 and a high risk of related complications.…”

Fragility fractures of the pelvis: An update

“…Fragility fractures of the pelvis (FFP) are a clinical entity with an increasing frequency. [1][2][3][4][5][6] A fragility fracture, as defined by the World Health Organization, is a fracture that is caused by an injury that would be insufficient to fracture normal bone; the result of reduced compressive and/or torsional strength of bone. [7] FFP are especially present in female patients of old age, suffering from osteoporosis.…”