TY - CHAP M1 - Book, Section TI - Pelvic Fracture-Related Hemorrhage A1 - Morales, David A1 - Reva, Viktor A1 - Fox, Charles J. A2 - DuBose, Joseph J. A2 - Teixeira, Pedro G. A2 - Rajani, Ravi R. PY - 2023 T2 - Vascular Injury: Endovascular and Open Surgical Management AB - Pelvic fractures have an overall incidence of 9.3% and are a common pattern observed with a blunt mechanism of injury.1 Pelvic ring disruption constitute 8.9% of all pelvic fractures and are more frequently noted in motorcycle collisions (15.5%) and struck pedestrians (13.8%).1 Exsanguination associated with severe pelvic fractures can be catastrophic. Although most patients who present with pelvic fractures arrive at the Emergency Department (ED) hemodynamically stable, 5% to 10% will arrive hemodynamically unstable due to hemorrhagic shock.2 The mortality rate for this group of patients was reported to be 32% by the American Association for the Surgery of Trauma (AAST) Pelvic Fracture Study Group3 and 21% in another 11-year series of preferential pre-peritoneal pelvic packing and external fixation.2 Overall, the mortality from pelvic fracture ranges widely based on the type of fracture and is highest in patients presenting with refractory hemorrhagic shock.1,3,4 Over a third of patients with pelvic fractures will require a blood transfusion, and the average transfusion is ~900 mL.1 More than half receive blood when the Abbreviated Injury Score (AIS) is ≥4 and when these fractures coexist with other associated abdominal injuries, 75% will receive a blood transfusion.1 Pelvic angiography may be necessary in 13% to 24% of those who have refractory shock and more than half of them will have therapeutic embolization with a variety of materials.1–4 SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1200600512 ER -