Patients with pelvic and/or acetabular fractures are at high risk of developing thromboembolic (TE) complications. In our study we investigate TE complications and the potential negative effects of concomitant pelvic or acetabular injuries in multiple injured patients according to pelvic/acetabular injury severity and fracture classification. The TraumaRegister DGU® was analyzed between 2010 and 2019. Multiple injured patients with pelvic and/or acetabular fractures with ISS ≥ 16 suffering from TE complications were identified. We conducted a univariate and multivariate analysis with TE events as independent variable to examine potential risk factors and contributing factors. 10.634 patients met our inclusion criteria. The overall TE incidence was 4.9%. Independent risk factors for the development of TE complications were sepsis, ≥ 10 operative interventions, mass transfusion (≥ 10 PRBCs), age ≥ 65 years and AISAbdomen ≥ 3 (all p < 0.001). No correlation was found for overall injury severity (ISS), moderate traumatic brain injury, additional injury to lower extremities, type B and C pelvic fracture according to Tile/AO/OTA and closed or open acetabular fracture. Multiple injured patients suffering from pelvic and/or acetabular fractures are at high risk of developing thromboembolic complications. Independent risk factors for the development of thromboembolic events in our study cohort were age ≥ 65 years, mass transfusion, AISAbdomen ≥ 3, sepsis and ≥ 10 surgery procedures. Among multiple injured patients with acetabular or pelvic injuries the severity of these injuries seems to have no further impact on thromboembolic risk. Our study, however, highlights the major impact of early hemorrhage and septic complications on thromboembolic risk in severely injured trauma patients. This may lead to individualized screening examinations and a patient-tailored thromboprophylaxis in high-risk patients for TE. Furthermore, the number of surgical interventions should be minimized in these patients to reduce thromboembolic risk.

中文翻译：

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多个骨盆损伤患者的血栓栓塞并发症：确定可能针对患者进行预防的风险因素

骨盆和/或髋臼骨折患者发生血栓栓塞 (TE) 并发症的风险很高。在我们的研究中，我们根据骨盆/髋臼损伤的严重程度和骨折分类，调查了多位受伤患者的 TE 并发症和伴随骨盆或髋臼损伤的潜在负面影响。TraumaRegister DGU® 在 2010 年至 2019 年间进行了分析。确定了多名患有骨盆和/或髋臼骨折且 ISS ≥ 16 且患有 TE 并发症的受伤患者。我们以 TE 事件作为自变量进行了单变量和多变量分析，以检查潜在的危险因素和影响因素。10.634 名患者符合我们的纳入标准。总 TE 发生率为 4.9%。TE 并发症发生的独立危险因素是败血症、≥ 10 次手术干预、大量输血（≥ 10 PRBCs）、年龄≥ 65 岁和 AISAbdomen ≥ 3（所有 p < 0.001）。未发现总体损伤严重程度 (ISS)、中度创伤性脑损伤、下肢额外损伤、根据 Tile/AO/OTA 的 B 型和 C 型骨盆骨折以及闭合性或开放性髋臼骨折之间存在相关性。多名患有骨盆和/或髋臼骨折的受伤患者发生血栓栓塞并发症的风险很高。在我们的研究队列中，发生血栓栓塞事件的独立危险因素是年龄 ≥ 65 岁、大量输血、AISAbdomen ≥ 3、败血症和≥ 10 次手术。在髋臼或骨盆损伤的多名受伤患者中，这些损伤的严重程度似乎对血栓栓塞风险没有进一步影响。然而，我们的研究，强调了早期出血和脓毒症并发症对严重创伤患者血栓栓塞风险的主要影响。这可能会导致 TE 高危患者的个体化筛查检查和患者量身定制的血栓预防。此外，应尽量减少这些患者的手术干预次数，以降低血栓栓塞风险。