Pelvic Ring Fractures Are an Independent Risk Factor for Death After Blunt Trauma
ABSTRACT It is unknown whether pelvic ring fracture is an independent predictor of death after blunt trauma. Few previous studies have attempted to analyze whether the high death rate observed in association with pelvic ring injury is secondary to the pelvic ring injury or merely related to many other injuries that typically are sustained in such cases. Our hypothesis was that pelvic ring fracture is an independent risk factor for death, even after accounting for the risk of death from other associated injuries.
We reviewed the records of 31,550 patients who presented with blunt trauma at our Level I trauma center from 1995 to 2002. We analyzed our prospectively collected database and excluded any patient who was missing more than one demographic parameter (n = 414, 1.3% of the data set). Our study group consisted of 1,017 patients with pelvic ring fractures and 30,119 patients with blunt trauma without pelvic ring fractures. Multiple logistic regression analysis was conducted to account for the relative contribution of associated clinical criteria to mortality. A mortality model was then designed by using the regression analysis, allowing us to compare a calculated chance of death for each patient in the study group. We then compared the expected number of deaths of patients with pelvic injury with the actual number of observed deaths in that data set. Additionally, we conducted a second statistical analysis with which we compared the death rate of our pelvic ring fracture population (n = 1,017) with a matched subgroup (n = 1,017) from our patient population without pelvic ring fractures (n = 30,119).
The presence of pelvic ring fracture was found to be an independent risk factor for mortality in the blunt trauma population based on both statistical methods (odds ratios, 1.9 [p < 0.001] and 2.1 [p < 0.0007]). Other significant predictors of mortality included patient age, Injury Severity Score, Glasgow Coma Scale score, systolic blood pressure and respiratory rate at admission, and several medical comorbidities.
The presence of pelvic ring fracture seems to represent a clinically significant independent risk factor for mortality, even after accounting for the association with potentially severe additional body system injuries.
- [Show abstract] [Hide abstract]
ABSTRACT: The harmonic contents and the waveform of the exciting current of the exciter concern the rotor faults of a brushless AC generator with a rotary rectifier very nearly. The principle of the fast Fourier transformer (FFT) in Matlab is described in this paper. Based on the work of Tian Mingxing et al., the harmonic contents of the exciting current of the exciter is calculated under the normal and fault conditions, and the results are confirmed by the values calculated and measured by Xio Leming (China ship repair, no.3, p.27-9, 1997). However, the present method is more facilely.Power Electronics and Motion Control Conference, 2004. IPEMC 2004. The 4th International; 09/2004
Conference Paper: The design of brushless DC motor servo system based on wavelet ANN[Show abstract] [Hide abstract]
ABSTRACT: The paper presents a new approach to brushless DC motor servo system, which is based on artificial neural network (ANN) and wavelet transform. The approach is designed based on a three-layer forward artificial neural network, which trains and replaces network parameters in-line using a gradient descending error algorithm. The working and fault states of brushless DC motor are detected, in which the time-frequency characteristics of discrete wavelet transform (DWT) and local maximum of modulus of continuous wavelet transform (CWT) are used. The simulation result shows that the system using the approach has very good dynamic and static performances, it is sensitive to fault and robust to noise, and it has a vast applying prospect.Machine Learning and Cybernetics, 2004. Proceedings of 2004 International Conference on; 09/2004
- [Show abstract] [Hide abstract]
ABSTRACT: The objectives of this study were to evaluate the ability of the Young-Burgess classification system to predict mortality, transfusion requirements, and nonorthopaedic injuries in patients with pelvic ring fractures and to determine whether mortality rates after pelvic fractures have changed over time. Retrospective review. Level I trauma center. One thousand two hundred forty-eight patients with pelvic fractures during a 7-year period. None. Mortality at index admission, transfusion requirement during first 24 hours, and presence of nonorthopaedic injuries as a function of Young-Burgess pelvic classification type. Mortality compared with historic controls. Despite a relatively large sample size, the ability of the Young-Burgess system to predict mortality only approached statistical significance (P = 0.07, Kruskal-Wallis). The Young-Burgess system differentiated transfusion requirements--lateral compression Type 3 (LC3) and anteroposterior compression Types 2 (APC2) and 3 (APC3) fractures had higher transfusion requirements than did lateral compression Type 1 (LC1), anteroposterior compression Type 1 (APC1), and vertical shear (VS) (P < 0.05)--but was not as useful at predicting head, chest, or abdomen injuries. Dividing fractures into stable and unstable types allowed the system to predict mortality rates, abdomen injury rates, and transfusion requirements. Overall mortality in the study group was 9.1%, unchanged from original Young-Burgess studies 15 years previously (P = 0.3). The Young-Burgess system is useful for predicting transfusion requirements. For the system to predict mortality or nonorthopaedic injuries, fractures must be divided into stable (APC1, LC1) and unstable (APC2, APC3, LC2, LC3, VS, combined mechanism of injury) types. LC1 injuries are very common and not always benign (overall mortality rate, 8.2%).Journal of orthopaedic trauma 10/2010; 24(10):603-9. DOI:10.1097/BOT.0b013e3181d3cb6b · 1.54 Impact Factor