The epidemiology of pelvic ring fractures: A population-based study

Zsolt Balogh*, Kate L. King, Peter Mackay, Debra McDougall, Stuart Mackenzie, Julie A. Evans, Timothy Lyons, Stephen A. Deane

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

162 Citations (Scopus)


BACKGROUND: The severity of pelvic ring fractures (PRFs) can range from minor injury with low-energy mechanism to high-energy injury causing prehospital death. The purpose of this study was to prospectively describe the comprehensive pelvic fracture occurrence in an inclusive trauma system. METHODS: A 12-month prospective, population-based epidemiologic study was performed in the Hunter Region, New South Wales, Australia (population of 600,000, served by one Level I trauma center and 7 referring hospitals). Patient demographics, mechanism, injury severity, shock parameters, and outcomes were recorded prospectively. The database included all pelvic fractures from the region: high-energy pelvic fractures (HE-PRFs), low-energy pelvic fractures (LE-PRFs), and prehospital deaths (PD-PRFs). RESULTS: The incidence of PRF in the trauma system was 23 per 100,000 persons (138 fractures). The incidences of HE-PRF and LE-PRF were each 10 per 100,000 persons, whereas there were 3 PD-PRFs per 100,000. HE-PRF compared with LE-PRF occurred predominantly in men (64% vs. 20%, p < 0.05), younger persons (41 ± 3 vs. 83 ± 1 years, p < 0.05), those who had a higher Injury Severity Score (23 ± 3 vs. 6 ± 1, p < 0.05), and those with lower blood pressure (111 ± 1 mm Hg vs. 153 ± 1 mm Hg, p < 0.05), but the inhospital mortality rate was not statistically different (15% vs. 8%, p = NS). The overall mortality of the cohort was 23% (60% of those were from the PD-PRF group). The PRF-related mortality was 7% (HE-PRF: 7%; LE-PRF: 2%; PD-PRF: 33%), which was always attributable to bleeding. The incidence of demonstrated pelvic fracture-related arterial bleeding was 1.3 per 100,000 persons per year. CONCLUSIONS: LE-PRF and HE-PRF are equally frequent among hospital admissions. They represent two distinct demographic groups with similar mortality rate. Most PRF-related deaths occur prehospitally. Bleeding remains the primary cause of PRF-related mortality in all groups.

Original languageEnglish
Pages (from-to)1066-1072
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number5
Publication statusPublished - Nov 2007
Externally publishedYes


  • Acute pelvic fixation
  • Epidemiology
  • Hemorrhagic shock
  • Pelvic angiography
  • Pelvic fixation
  • Pelvic fracture


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