Effects of early use of external pelvic compression on transfusion requirements and mortality in pelvic fractures

Background: We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. Methods: Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fracture in patients older than 55 years of age, or (3) fracture with sytemic hypotension. Starting in November of 2003, EMC was performed using circumferential pelvic binders on patient arrival and continued for 24 to 72 hours. Patients who underwent EMC (n = 118) were compared with historical controls in the preceding year (n = 119). Results: Patients in the EMC and control groups had similar fracture patterns, age, and injury severity. EMC had no effect on mortality (23% vs 23%, P = .92), need for pelvic angioembolization (11% vs 15%, P = .35), or 24-hour transfusions (5.2 ± 10 vs 4.6 ± 9 U, P = .64). Conclusions: Early EMC with pelvic binders does not reduce hemorrhage or mortality associated with pelvic fractures.