Predictors of prolonged hospital stay of pelvic ring and acetabular fractures - a retrospective analysis in a 10-year period of a level 1 trauma center.

Abstract

Background: Pelvic ring and acetabular fractures are among the most complicated and severe injury patterns in orthopaedic trauma surgery. Inpatient treatment is not only costly but also very time-consuming. The aim of this study is to identify predictors leading to a prolonged length of hospital stay.

Methods: This study is a retrospective review of data of 211 patients admitted to a Level-1 trauma centre. In this cohort a surgical treatment of pelvic ring and acetabular fractures between 2010 and 2020 was performed. Preclinical data and clinical parameters were analysed.

Results: Injury severity was the most important factor for a prolonged stay. High-energy trauma resulted in significantly longer hospital stays. Multiple injury had a significant effect. Low haemoglobin levels measured on admission and an increased shock index, as indicators of the severe trauma, could be identified as good predictors of a longer intensive care period and a long total length of stay. Except for the number of surgical procedures to treat the pelvic fracture, surgical approach and technique showed no predictive value. Age and gender do not play a role. Increased patient age does not result in a longer hospital stay or longer intensive care times.

Conclusion: Pelvic fractures demonstrate a prolonged hospital stay. It depends on the severity of the injury. There are good predictors of a long length of stay at admission. These include the presence of multiple injury, the complexity of the fractures, haemoglobin levels, and the shock index.