Classification of soft-tissue injuries in open femur fractures- Relevant for systemic complications?.

Background: A broad range of systemic complications has been described to occur in patients with open major fractures. Various causes have been claimed to play a role. We therefore surveyed a nationwide trauma registry to assess risk factors associated with closed and various types of open femur fractures. Methods: Cohort study in a nationwide population-based prospective database. Inclusion criteria for selection from database: individuals with femur fracture, age >=16 years, and survival until primary admission. Main groups: closed and open femur fracture. Patient demographics, injury severity (New Injury Severity Score, NISS), surgical fracture management, length of stay (LOS) and systemic complications (e.g. multiple organ failure (MOF), sepsis, mortality) were collected and statistically analyzed using SPSS statistics. Multivariate regression analysis was performed to stratify subgroups for the degree of open soft-tissue injury according to Gustilo and Anderson. Results: Among 32582 documented trauma victims (01/01/02-12/31/10); a total of 5761 met the inclusion criteria. Main groups: 4423 closed (76.8%) and 1338 open femur fractures (23.2%). Open fractures subgroups were divided into I[degrees] (334, 28.1%), II[degrees] (526, 44.3%) and III[degrees] (328, 27.6%). Open fractures were associated with an increased risk for pre-hospital hemorrhagic shock (p=0.01), higher resuscitation requirements (p

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2aXxv4z