Patient-related quality of life after pelvic ring fractures in elderly

Int Orthop. 2019 Feb;43(2):261-267. doi: 10.1007/s00264-018-4030-8. Epub 2018 Jun 26.

Abstract

Purpose: Pelvic ring fractures, occurring in elderly patients are a challenging problem. Little known is about the patient-related outcome after these injuries. The primary objective of this study is to evaluate the quality of life after pelvic ring injuries in patients aged over 60 years.

Methods: Patients (≥ 60 years) with pelvic ring fractures treated in our trauma department between 2004 and 2014 were included. Next to patient data, injury-related details as well as treatment details were assessed. After a follow-up of at least two years, the survival rate and the patient-related outcome were evaluated using the SF-36 and the EQ-5D score.

Results: One hundred ninety-six patients (138 women; 58 men; mean age 75.3 ± 7.8 years) were identified. Ninety-six patients were treated operatively, 100 patients conservatively. The overall complication rate was significantly lower for conservatively compared to operatively treated patients (conservatively 18% vs. operatively 33%; p = 0.014). The total mortality rate over 2 years is 29% with no significant difference of the two-year survival rate (2-year survival rate: operatively 77% vs. non-operatively 65%; p = 0.126). Fifty-five patients completed the SF-36 and EQ-5D score after a mean follow-up of 4.2 ± 2.9 years. The mean physical component score of the SF-36 is 33.6 ± 8.3, and the mean mental component score is 45.3 ± 8.4. The mean EQ-5D VAS reached 62.5 ± 27.9.

Conclusion: Elderly patients with pelvic ring fractures show a high mortality rate and a limited patient-related outcome. While the complication rate of conservatively treated patients is lower compared to operated patients, the two year survival rate is steady.

Keywords: EQ-5D; Elderly patients; Patient-related outcome; Pelvic ring fractures; SF-36.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Conservative Treatment
  • Female
  • Fractures, Bone / surgery*
  • Humans
  • Male
  • Pelvic Bones / injuries
  • Pelvis
  • Quality of Life*
  • Survival Rate