Purpose
Pelvis fractures are associated with bladder and urethral injury (BUI). The purpose of this study was to identify risk factors associated with BUI in patients with pelvic fracture.
Methods
Patients (> 18 years) with pelvic injury (N = 314) at our hospital between January 2015 and June 2020 were retrospectively analyzed for age, sex, cause of injury, initial vital signs, urine red blood cell (RBC) count, Glasgow Coma Scale and Abbreviated Injury Scale score, Injury Severity Score, preperitoneal pelvic packing, and femur, lumbar spine, and pelvic fractures.
Results
Compared with the BUI-absent group, the BUI-present group had a greater percentage of patients who were male (79.2% vs. 55.9%; p = 0.026), had a urine RBC count/high power field (HPF) ≥ 30 (94.4% vs. 38.8%; p < 0.001), underwent preperitoneal pelvic packing (37.5% vs. 18.6%; p = 0.035), had symphysis pubis diastasis (33.3% vs. 11.7%; p = 0.008), and had sacroiliac joint dislocation (54.2% vs. 23.4%; p = 0.001). Independent risk factors associated with BUI were symphysis pubis diastasis [odds ratio (OR) was 3.958 (95% confidence interval: 1.191–13.154); p = 0.025] and a urine RBC count/HPF ≥ 30 [OR = 25.415 (95% confidence interval: 3.252–198.637); p = 0.006]. Of those with BUI, 15 patients were diagnosed at the trauma bay, and 9 had a delayed diagnosis.
Conclusion
Patients with pelvic injury who display symphysis pubis diastasis or have a urine RBC count/ HPF ≥ 30 are at higher risk of BUI, therefore, further BUI investigations should be considered.

Citations

• Hematuria as a Screening Tool for Bladder and Urethral Injuries in Pelvic Trauma: A Sensitivity and Specificity Analysis
  Md Habibur Rahman, Muktadir Tamim, Goutom Mukharzi
  TAJ: Journal of Teachers Association.2024; 37(2): 802.     CrossRef

Purpose:

The aim of this study is to investigate the clinical characteristics and epidemiology of stab wound in a single center for 5 years.

Methods:

Eighty-seven patients visited the emergency room with stab wounds between March 2008 and October 2013. Patient demographics, location of the wound, injured internal organ, and clinical parameters were reviewed.

Results:

Among eighty seven patients, 59 were male, and the mean age was 45.6 years old (range, 18∼85 years old). The most common age group was fifth and sixth decades. The most common cause of stab injury was self-infliction (32 cases), followed by violence (31 cases) and accident (23 cases). Self-infliction injuries were associated with underlying psychological problems in 20 patients. The most common injured sites were abdomen (48 cases), followed by thorax (20 cases) and neck (12 cases). Emergent exploration was required in 37 patients. Four patients (4.6%) were dead due to hypovolemic shock after injury of the thorax (lung) or neck (transection of carotid artery and transection of trachea). The length of hospital stay was 3 days (0∼6.5 days) and the injury severity score (ISS) was 4 points (1∼9 points). ISS was associated with the length of hospital stay (p<0.001) and emergency exploration (p=0.001).

Conclusion:

Self-inflicted injury was the most common cause of stab injury and it was related to psychologic problems. The most common injured site was abdomen.

Citations

• Epidemiology of Knife Injuries at Ain Shams University Hospital Emergency Department from 2018 to 2019: A Cross-Sectional Study
  Manar M Ellaban, Eman Afifi, Moustafa El Houssinie, Jon Mark Hirshon, Mohamed El-Shinawi, Maged El-Setouhy
  Open Access Emergency Medicine.2021; Volume 13: 561.     CrossRef