Introduction
Materials and methods
Results
Demographics
FFP type | FFP I–IV | FFP type I | FFP type II | FFP type III | FFP type IV | p value |
---|---|---|---|---|---|---|
Total number of patients | 500 | 138 | 238 | 30 | 94 | |
Number of operated patients (n, %) | 140 (28) | 2 (1.4) | 52 (21.8) | 18 (60) | 68 (72.3) | |
Mean age (years, SD) | 77.4 (9.9) | 69.0 (10.0) | 78.7 (8.1) | 78.6 (11.9) | 76.3 (10.2) | 0.37 |
Women (n, %) | 125 (89.3) | 2 | 45 (86.5) | 16 (88.9) | 62 (91.2) | 0.69 |
Men (n, %) | 15 (10.7) | 0 | 7 (13.5) | 2 (11.1) | 6 (8.8) | 0.69 |
Patients with comorbidities (n, %) | 129 (92.1) | 2 | 49 (94.2) | 17 (94.4) | 61 (89.7) | 0.75 |
Patients with two or more comorbidities (n, %) | 69 (49.3) | 2 | 27 (51.9) | 9 (50.0) | 31 (45.6) | 0.78 |
Cardiovascular disease (n, %) | 120 (85.7) | 2 | 48 (92.3) | 15 (83.3) | 55 (80.9) | 0.21 |
Osteopororsis (n, %) | 90 (64.3) | 2 | 32 (61.5) | 10 (55.6) | 46 (67.6) | 0.58 |
Malignancy (n, %) | 32 (22.9) | 1 | 8 (15.4) | 4 (22.2) | 19 (27.9) | 0.26 |
Diabetes mellitus (n, %) | 27 (19.3) | 0 | 15 (28.8) | 4 (22.2) | 8 (11.8) | 0.07 |
Dementia (n, %) | 12 (8.6) | 0 | 4 (7.7) | 2 (11.1) | 6 (8.8) | 0.84 |
Pulmonary disease (n, %) | 17 (12.1) | 2 | 6 (11.5) | 2 (11.1) | 7 (10.3) | 1 |
Rheumatoid arthritis (n, %) | 9 (6.4) | 0 | 5 (9.6) | 0 | 4 (5.9) | 0.45 |
Operative procedure
FFP categories | FFP I–IV | FFP type I | FFP type II | FFP type III | FFF type IV | p value | |
---|---|---|---|---|---|---|---|
Number of operatively treated patients | 140 | 2 | 52 | 18 | 68 | ||
Posterior pelvis | O or P | ||||||
IS screws unilateral | P | 30 | 0 | 25 | 3 | 2 | < 0.001 |
IS screws bilateral | P | 7 | 0 | 2 | 1 | 4 | 0.88 |
IS screw with plate and screw osteosynthesis ilium | O | 2 | 0 | 0 | 1 | 1 | 0.24 |
Transsacral bar | P | 29 | 0 | 9 | 1 | 19 | 0.09 |
Transsacral bar with unilateral IS screw | P | 16 | 0 | 7 | 3 | 6 | 0.46 |
Transsacral bar with bilateral IS screws | P | 36 | 0 | 6 | 0 | 30 | < 0.001 |
Transsacral bar with plate and screw osteosynthesis ilium | O | 2 | 0 | 0 | 0 | 2 | 0.63 |
Transiliac bridging plate osteosynthesis with bilateral IS screws | P | 1 | 0 | 0 | 0 | 1 | 1 |
Plate and screw osteosynthesis ilium | O | 10 | 0 | 0 | 9 | 1 | < 0.001 |
Internal fixator | P | 1 | 0 | 1 | 0 | 0 | 0.51 |
Internal fixator with bilateral IS screws | P | 1 | 0 | 0 | 0 | 1 | 1 |
Lumbopelvic fixation with bilateral IS screws | O | 1 | 0 | 0 | 0 | 1 | 1 |
Sum | 136 | 0 | 50 | 18 | 68 | 0.38 | |
Number of operatively treated patients | 140 | 2 | 52 | 18 | 68 | ||
Anterior pelvis | O or P | ||||||
Unilateral retrograde transpubic screw | P | 48 | 0 | 29 | 6 | 13 | < 0.001 |
Bilateral retrograde transpubic screw | P | 9 | 1 | 4 | 1 | 3 | 0.78 |
Retrograde transpubic screw and plate and screw osteosynthesis | O | 3 | 0 | 1 | 0 | 2 | 1 |
Plate and screw osteosynthesis | O | 28 | 1 | 5 | 7 | 15 | 0.02 |
Plate and screw osteosynthesis and external fixator | O | 2 | 0 | 0 | 0 | 2 | 0.63 |
Sum | 90 | 2 | 39 | 14 | 35 | 0.01 | |
Patients who received percutaneous procedures only (P-group)(n, %) | P | 99 (70.7) | 1 | 46 (88.5) | 6 (33.3) | 46 (67.6) | < 0.001 |
Patients who received open procedures (O-group) (n, %) | O | 41 (29.3) | 1 | 6 (11.5) | 12 (66.7) | 22 (32.4) | < 0.001 |
Postoperative course
FFP type I–IV | FFP type I | FFP type II | FFP type III | FFP type IV | p value | |
---|---|---|---|---|---|---|
All patients (n) | 140 | 2 | 52 | 18 | 68 | |
Open procedures (n; %) | 41 (29.3) | 1 | 6 (11.5) | 12 (66.7) | 22 (32.4) | < 0.001 |
Median LoS (days) | 18 | 9.5 | 17 | 21 | 18 | 0.65 |
Minimum (days) | 3 | 9 | 3 | 10 | 6 | |
Maximum (days) | 92 | 10 | 92 | 56 | 68 | |
IQR (days) | 14–25 | 9.25–9.75 | 14.8–25.0 | 14.5–24.5 | 13–25.5 | |
Median postoperative LoS (days) | 12 | 6 | 12 | 14.5 | 12 | 0.3 |
Minimum (days) | 2 | 2 | 3 | 8 | 3 | |
Maximum (days) | 74 | 10 | 74 | 49 | 51 | |
IQR (days) | 9–17 | 4–8 | 9–15 | 11.25–17.75 | 9–18 | |
Patients with general in-hospital complications (n, %) | 51 (36.4) | 0 | 14 (26.9) | 12 (66.7) | 24 (35.3) | 0.01 |
Urinary tract infection (UTI) (n, %) | 37 (26.4) | 0 | 10 (19.2) | 9 (50.0) | 18 (26.5) | 0.046 |
Pneumonia (n, %) | 7 (5.0) | 0 | 3 (5.8) | 1 (5.6) | 3 (4.4) | 1 |
Cardiovascular (n, %) | 4 (2.9) | 0 | 3 (5.8) | 0 (0.0) | 1 (1.5) | 0.35 |
Bedsore (without skin necrosis) (n, %) | 11 (7.9) | 0 | 5 (9.6) | 3 (16.7) | 3 (4.4) | 0.13 |
Thrombosis (n, %) | 4 (2.9) | 0 | 2 (3.8) | 0 (0.0) | 2 (2.9) | 1 |
Lung embolism (n, %) | 2 (1.4) | 0 | 1 (1.9) | 1 (5.5) | 0 (0.0) | 0.12 |
Patients with surgery-related complications (n, %) | 37 (26.4) | 1 | 11 (21.2) | 8 (44.4) | 17 (25) | 0.15 |
Hematoma (n, %) | 10 (7.1) | 0 | 3 (5.8) | 1 (5.6) | 6 (8.8) | 0.90 |
Infection (n, %) | 7 (5) | 0 | 3 (5.8) | 2 (11.1) | 2 (2.9) | 0.29 |
Implant malposition (n, %) | 2 (1.4) | 0 | 2 (3.8) | 0 | 0 | 0.38 |
Implant loosening (n, %) | 13 (9.3) | 0 | 4 (7.7) | 2 (11.1) | 7 (10.3) | 0.85 |
Implant failure (n, %) | 3 (2.1) | 0 | 1 (1.9) | 1 (5.6) | 1 (1.5) | 0.51 |
Dysesthesia–paresis (n, %) | 7 (5) | 0 | 2 (3.8) | 3 (16.7) | 2 (2.9) | 0.08 |
Suprapubic hernia (n, %) | 2 (1.4) | 1 | 1 (1.9) | 0 | 0 | 0.51 |
Patients with surgical revision (%) | 25 (17.9) | 1 | 9 (17.3) | 4 (22.2) | 11 (16.2) | 0.78 |
Percutaneous versus open procedures
Type of treatment | All patients | P-group | O-group | p value |
---|---|---|---|---|
Number of patients (%) | 140 (100) | 99 (70.7) | 41 (29.3) | |
Mean age (years, SD) | 77.4 (10.7) | 77.6 (10.2) | 77.0 (8.9) | 0.78 |
Women (n, %) | 125 (89.3) | 89 (89.9) | 36 (87.8) | 0.77 |
Men (n, %) | 15 (10.7) | 10 (10.1) | 5 (12.2) | 0.77 |
Patients with comorbidities (n, %) | 129 (92.1) | 91 (91.9) | 38 (92.7) | 1 |
Patients with two or more comorbidities (n, %) | 69 (49.3) | 50 (50.5) | 19 (46.3) | 0.65 |
Median LoS (days) | 18 | 17 | 20 | 0.12 |
Minimum (days) | 3 | 3 | 9 | |
Maximum (days) | 92 | 72 | 92 | |
IQR (days) | 14–25 | 14–25 | 14–28 | |
Median LoS postoperative (days) | 12 | 12 | 14 | 0.009 |
Minimum postoperative (days) | 2 | 2 | 7 | |
Maximum postoperative (days) | 74 | 65 | 74 | |
IQR (days) | 9–17 | 8.5–15 | 10–21 | |
Patients with general complications (n, %) | 51 (36.4) | 37 (37.4) | 14 (34.1) | 0.72 |
Urinary tract infection (n, %) | 37 (26.4) | 26 (26.3) | 11 (26.8) | 0.94 |
Pneumonia (n, %) | 7 (5.0) | 6 (6.1) | 2 (4.9) | 1 |
Cardiovascular (n, %) | 4 (2.9) | 4 (4.0) | 0 (0.0) | 0.32 |
Bedsore (n, %) | 11 (7.9) | 7 (7.1) | 4 (9.8) | 0.73 |
Thrombosis (n, %) | 4 (2.9) | 3 (3.0) | 1 (2.4) | 1 |
Lung embolism (n, %) | 2 (1.4) | 0 (0.0) | 2 (4.9) | 0.08 |
Patients with surgical complications (%) | 37 (26.4) | 19 (19.2) | 18 (43.9) | 0.006 |
Hematoma (n, %) | 10 (7.1) | 7 (7.1) | 3 (7.3) | 1 |
Infection (n, %) | 7 (5) | 4 (4.0) | 3 (7.3) | 0.42 |
Implant malposition (n, %) | 2 (1.4) | 1 (1.0) | 1 (2.4) | 0.5 |
Implant loosening (n, %) | 13 (9.3) | 7 (7.1) | 6 (14.6) | 0.2 |
Implant failure (n, %) | 3 (2.1) | 0 | 3 (7.3) | 0.02 |
Dysesthesia–paresis (n, %) | 7 (5) | 3 (3.0) | 4 (9.8) | 0.19 |
Suprapubic hernia (n, %) | 2 (1.4) | 0 | 2 (4.9) | 0.08 |
Patients with surgical revisions (%) | 25 (17.9) | 13 (13.1) | 12 (29.3) | 0.02 |
Mobility and destination at discharge
FFP type | FFP type I–IV | FFP type I | FFP type II | FFP type III | FFP type IV | p value |
---|---|---|---|---|---|---|
All patients | 140 | 2 | 52 | 18 | 68 | |
Mobility at discharge not documented | 6 | 0 | 3 | 0 | 3 | |
Documented patients (n, %) | 134 (100) | 2 | 49 (100) | 18 (100) | 65 (100) | |
Ward (n, %) | 54 (40.3) | 1 | 22 (44.9) | 5 (27.8) | 26 (40.0) | 0.45 |
Room (n, %) | 21 (15.7) | 0 | 8 (16.3) | 3 (16.7) | 10 (15.4) | 1 |
Transfer (n, %) | 52 (38.8) | 1 | 18 (36.7) | 9 (50.0) | 24 (36.9) | 0.57 |
Bed (n, %) | 7 (5.2) | 0 | 1 (2.1) | 1 (5.6) | 5 (7.7) | 0.35 |
Walkers (n, %) | 75 (56.0) | 1 | 30 (61.2) | 8 (44.4) | 36 (55.4) | 0.47 |
Non-walkers (n, %) | 59 (44.0) | 1 | 19 (38.8) | 10 (55.6) | 29 (44.6) | 0.47 |
Type of treatment | All patients | P-group | O-group | p value |
---|---|---|---|---|
All patients | 140 | 99 | 41 | |
Mobility at discharge not documented | 6 | 6 | 0 | |
Documented patients (n, %) | 134 (100) | 93 (100) | 41 (100) | |
Ward (n, %) | 54 (40.3) | 39 (41.9) | 15 (36.6) | 0.76 |
Room (n, %) | 21 (15.7) | 17 (18.3) | 4 (9.8) | 0.31 |
Transfer (n, %) | 52 (38.8) | 35 (37.6) | 17 (41.5) | 0.5 |
Bed (n, %) | 7 (5.2) | 2 (2.2) | 5 (12.2) | 0.02 |
Walkers (n, %) | 75 (56.0) | 56 (60.2) | 19 (46.3) | 0.13 |
Non-walkers (n, %) | 59 (44.0) | 37 (39.8) | 22 (53.7) | 0.13 |
FFP type II–IV | Pre-hospital | Discharge | p value | FFP type II | Pre-hospital | Discharge | p value |
---|---|---|---|---|---|---|---|
All patients | 138 | 138 | All patients | 52 | 52 | ||
Not documented | 8 | 5 | Not documented | 3 | 1 | ||
Documented patients (n, %) | 130 (100) | 133 (100) | Documented patients (n, %) | 49 (100) | 51 (100) | ||
Home (n, %) | 111 (85.4) | 38 (28.6) | < 0.001 | Home (n, %) | 42 (85.7) | 19 (37.3) | < 0.001 |
Geriatrics (n, %) | 12 (9.2) | 49 (36.8) | < 0.001 | Geriatrics (n, %) | 5 (10.2) | 11 (21.6) | 0.12 |
Rehabilitation (n, %) | 2 (1.5) | 38 (28.6) | < 0.001 | Rehabilitation (n, %) | 1 (2.0) | 18 (35.3) | < 0.001 |
Hospital (n, %) | 5 (3.8) | 8 (6.0) | 0.42 | Hospital (n, %) | 1 (2.0) | 3 (5.9) | 0.61 |
p value for all subgroups | < 0.001 | p value for all subgroups | < 0.001 | ||||
Independent (n, %) | 111 (85.4) | 38 (28.6) | Independent (n, %) | 42 (85.7) | 19 (37.3) | ||
Dependent (n, %) | 19 (14.6) | 95 (71.4) | < 0.001 | Dependent (n, %) | 7 (14.3) | 32 (62.7) | < 0.001 |
FFP type III | Pre-hospital | Discharge | p value | FFP type IV | Pre-hospital | Discharge | p value |
---|---|---|---|---|---|---|---|
All patients | 18 | 18 | All patients | 68 | 68 | ||
Not documented | 1 | 0 | Not documented | 4 | 4 | ||
Documented patients (n, %) | 17 (100) | 18 (100) | Documented patients (n, %) | 64 (100) | 64 (100) | ||
Home (n, %) | 16 (94.1) | 7 (38.9) | < 0.001 | Home (n, %) | 53 (82.8) | 12 (18.8) | < 0.001 |
Geriatrics (n, %) | 1 (5.9) | 7 (38.9) | 0.04 | Geriatrics (n, %) | 6 (9.4) | 31 (48.4) | < 0.001 |
Rehabilitation (n, %) | 0 | 3 (16.7) | 0.23 | Rehabilitation (n, %) | 1 (1.6) | 17 (26.6) | < 0.001 |
Hospital (n, %) | 0 | 1 (5.6) | 1 | Hospital (n, %) | 4 (6.2) | 4 (6.2) | 1 |
p value for all subgroups | 0.003 | p value for all subgroups | < 0.001 | ||||
Independent (n %) | 16 (94.1) | 7 (38.9) | Independent (n, %) | 53 (82.8) | 12 (18.8) | ||
Dependent (n %) | 1 (5.7) | 11 (61.1) | < 0.001 | Dependent (n, %) | 11 (17.2) | 52 (81.2) | < 0.001 |
P-group | Pre-hospital | Discharge | p value | O-group | Pre-hospital | Discharge | p value |
---|---|---|---|---|---|---|---|
All patients | 99 | 99 | All patients | 41 | 41 | ||
Not documented | 5 | 4 | Not documented | 3 | 1 | ||
Documented patients | 94 (100) | 95 (100) | Documented patients (%) | 38 (100) | 40 (100) | ||
Home (n, %) | 78 (83.0) | 28 (29.5) | < 0.001 | Home (n, %) | 35 (92.1) | 11 (27.5) | < 0.001 |
Geriatrics (n, %) | 10 (10.6) | 31 (32.6) | < 0.001 | Geriatrics (n, %) | 2 (5.3) | 18 (45.0) | < 0.001 |
Rehabilitation (n, %) | 2 (2.1) | 31 (32.6) | < 0.001 | Rehabilitation (n, %) | 0 (0.0) | 8 (20.0) | 0.005 |
Hospital (n, %) | 4 (4.3) | 5 (5.3) | 1 | Hospital (n, %) | 1 (2.6) | 3 (7.5) | 0.62 |
p value for all subgroups | < 0.001 | p value for all subgroups | < 0.001 | ||||
Independent (n, %) | 78 | 28 | Independent (n, %) | 35 | 11 | ||
Dependent (n, %) | 16 | 67 | < 0.001 | Dependent (n, %) | 3 | 29 | < 0.001 |
Follow-up
FFP-type | FFP Type I-IV | FFP Type I | FFP Type II | FFP Type III | FFP Type IV | p-value |
---|---|---|---|---|---|---|
Number of operated patients | 140 | 2 | 52 | 18 | 68 | |
One-year mortality (%) | 9.7 | 0 | 8 | 12.5 | 11.8 | |
Two-year mortality (%) | 15.7 | 0 | 8 | 26 | 19.5 | |
Five-year mortality (%) | 41.5 | 0 | 33.2 | 26 | 51 | |
Overall mortality | 0.428 | |||||
Patients who died before follow up (%) | 34 (24.3) | 0 | 11 (21.2) | 5 (27.8) | 18 (26.5) | |
Patients lost to follow up (%) | 15 (10.7) | 0 | 6 (11.5) | 2 (11.1) | 7 (10.3) | |
Patients with follow-up (%) | 91 (65.0) | 2 | 35 (67.3) | 11 (61.1) | 43 (63.2) | |
Surviving patients with follow up (%) | 91 (85.8) | 2 | 35 (85.4) | 11 (84.6) | 43 (86.0) | |
Median follow up time (months) | 40 | 42 | 42 | 47 | 39 | |
Patients with SF-8 (n, %) | 60/91 (65.9) | 2/2 | 16/35 (45.7) | 5/11 (45.5) | 37/43 (86.0) | |
Median SF-8 physical (PCS) | 32.43 | 46.12 | 29.39 | 27.88 | 32.88 | 0.61 |
Min SF-8 physical | 17.34 | 34.92 | 17.34 | 22.54 | 18.59 | |
Max SF-8 physical | 57.32 | 57.32 | 56.68 | 42.43 | 55.50 | |
Median SF-8 mental (MCS) | 54.42 | 56.50 | 55.42 | 50.21 | 54.67 | 0.32 |
Min SF-8 mental | 17.71 | 53.93 | 19.83 | 17.85 | 17.71 | |
Max SF-8 mental | 69.22 | 59.08 | 65.17 | 58.61 | 69.22 | |
Patients with PMS (n, %) | 91/91 (100.0) | 2/2 | 35/35 (100.0) | 11/11 (100.0) | 43/43 (100.0) | |
Median PMS | 5 | 6.5 | 6 | 3 | 5 | 0.20 |
Min PMS | 0 | 4 | 0 | 0 | 0 | |
Max PMS | 9 | 9 | 9 | 9 | 9 | |
Patients with NRS (n, %) | 89/91 (97.8) | 2/2 | 35/35 (100.0) | 10/11 (90.9) | 42/43 (97.7) | |
Median NRS | 4 | 0 | 5 | 4 | 4 | 0.86 |
Min NRS | 0 | 0 | 0 | 0 | 0 | |
Max NRS | 10 | 0 | 9 | 7 | 10 | |
Type of treatment | All patients | P-group | O-group | p value | ||
Number of operated patients | 140 | 99 | 41 | |||
One-year mortality (%) | 9.7 | 11.5 | 7.7 | |||
Two-year mortality (%) | 15.7 | 12.8 | 23.7 | |||
Five-year mortality (%) | 41.5 | 43.3 | 32.4 | |||
Overall mortality | 0.831 | |||||
Patients who died before follow up (%) | 34 (24.3) | 26 (26.3) | 8 (19.5) | |||
Patients lost to follow up (%) | 15 (10.7) | 13 (13.1) | 2 (4.9) | |||
Patients with follow-up (%) | 91 (65.0) | 60 (60.6) | 31 (75.6) | |||
Surviving patients with follow up (%) | 91 (85.8) | 60 (82.2) | 31 (93.9) | |||
Median follow up time (months) | 40 | 39.6 | 40.5 | |||
Patients with SF-8 (n, %) | 60/91 (65.9) | 38/60 (63.3) | 22/31 (71.0) | |||
Median SF-8 physical (PCS) | 32.43 | 32.64 | 31.22 | 0.68 | ||
Min SF-8 physical | 17.34 | 17.34 | 18.59 | |||
Max SF-8 physical | 57.32 | 56.68 | 57.32 | |||
Median SF-8 mental (MCS) | 54.42 | 54.26 | 58.82 | 0.22 | ||
Min SF-8 mental | 17.71 | 17.71 | 17.85 | |||
Max SF-8 mental | 69.22 | 67.27 | 69.22 | |||
Patients with PMS (n, %) | 91/91 (100.0) | 60/60 (100.0) | 31/31 (100.0) | |||
Median PMS | 5 | 6 | 4 | 0.07 | ||
Min PMS | 0 | 0 | 0 | |||
Max PMS | 9 | 9 | 9 | |||
Patients with NRS (n, %) | 89/91 (97.8) | 59/60 (98.3) | 30/31 (96.8) | |||
Median NRS | 4 | 3 | 4 | 0.30 | ||
Min NRS | 0 | 0 | 0 | |||
Max NRS | 10 | 9 | 10 |