Essential Factors in Predicting the Need for Angio-Embolization in the Acute Treatment of Pelvic Fracture with Hemorrhage

PURPOSE@#The purpose of this study was to determine the essential factors for prompt arrangement of angio-embolization in patients with pelvic ring fractures.@*METHODS@#A total of 62 patients with pelvic ring fractures who underwent angioembolization in Dankook University Hospital from March 2013 to June 2018 were retrospectively reviewed. There were 38 men and 24 women with a mean age of 59.8 years. The types of pelvic ring fractures were categorized according to the Tile classification. Patient variables included sex, initial hemoglobin concentration, initial systolic blood pressure, transfused packed red blood cells within 24 hours, Injury Severity Score (ISS), mortality rate, length of hospital stay, and time to angio-embolization.@*RESULTS@#The most common pelvic fracture pattern was Tile type B (n=34, 54.8%). The mean ISS was 27.3±10.9 with 50% having an ISS ≥25. The mean time to angio-embolization from arrival was 173.6±89 minutes. Type B (180.1±72.3 minutes) and type C fractures (174.7±91.3 minutes) required more time to angio-embolization than type A fractures (156.6±123 minutes). True arterial bleeding was identified in types A (35.7%),B (64.7%), and C (71.4%).@*CONCLUSIONS@#It is important to save time to reach the angio-embolization room in treating patients with pelvic bone fractures. Trauma surgeons need to consider prompt arrangement of angio-embolization when encountering Tile type B or C pelvic fractures due to the high risk of true arterial bleeding.

Reliability of Singh Index in Female Patients Older than 65 Years with Proximal Femoral Fracture / 대한골다공증학회지

OBJECTIVES: To evaluate osteoporosis in acute trauma situations, we compared reliability of Singh index values with bone mineral density in female patients older than 65 years with proximal femur fractures. MATERIALS AND METHODS: We enrolled 145 patients who treated between June 2006 and May 2011. The radiograph was done and assessed by 3 observers to determine Singh index values. The reliability of Singh index was expressed in terms of intraobserver and interobserver agreements using Fleiss's overall Kappa values, Pearson correlation coefficients, Kendall's Tau-b values. Correlation of bone mineral density and Singh index was measured using linear by linear association. RESULTS: Kappa values for intraobserver agreement ranged from 0.361 to 0.454. Kappa values for interobserver agreement ranged from 0.325 to 0.423 neither did not reach good reliability overall. There was no statistically significant correlation between Singh index and bone mineral density. CONCLUSIONS: Singh index is inappropriate method for clinic and research work due to poor interobserver agreement, though it is a simple and inexpensive method of assessing the osteoporosis in acute trauma patients.