Abstract
Bladder rupture is a potentially serious injury in blunt trauma patients. We determined whether location and displacement of pelvic fractures and the degree of hematuria can accurately predict bladder injury. A retrospective database of 721 blunt trauma pelvic fractures that presented to a single large regional level 1 trauma center between January 1, 1997, and July 15, 2003, was expanded to include data on bladder injury and the initial urinalysis. Multiple logistic regression was performed to determine if an association exists between pelvic fracture pattern, degree of hematuria, and bladder injury. A potential clinical prediction rule was then derived using a point system for four independent, significant risk factors identified from the logistic regression results. There were 37 bladder ruptures (5.0%), all of which presented with hematuria >30 red blood cells per high-powered field (RBC/HPF). Pelvic injuries that were independently associated with bladder injury included diastasis of the pubic symphysis >1 cm, RR = 9.8 (95% CI 4.6-20.9), and fracture of the obturator ring with displacement >1 cm RR = 3.2 (95% CI 1.6-6.5). No patient with isolated acetabular fractures sustained bladder injury. A clinical prediction rule was...Continue Reading
References
Jun 1, 1978·Urology·S LoeningW W Bonney
Dec 1, 1990·AJR. American Journal of Roentgenology·J W Young, C S Resnik
Mar 1, 1989·Urology·A S Cass, M Luxenberg
Sep 26, 1985·The New England Journal of Medicine·J H WassonL Goldman
Aug 1, 1984·The Journal of Urology·P R Carroll, J W McAninch
Oct 1, 1983·The Journal of Urology·J K PalmerJ N Corriere
Jun 1, 1994·The Australian and New Zealand Journal of Surgery·L ChanS Deane
Jun 1, 1993·The American Surgeon·G M FuhrmanC A Buerk
Feb 12, 1997·JAMA : the Journal of the American Medical Association·A LaupacisI G Stiell
Jun 15, 1999·World Journal of Urology·J N Corriere, C M Sandler
Jan 11, 2000·AJR. American Journal of Roentgenology·D E MorganL W Rue
Sep 27, 2001·JAMA : the Journal of the American Medical Association·P G ShekelleS H Woolf
Oct 5, 2001·The Journal of Trauma·A F MoreyS B Brandes
Feb 9, 2002·The Journal of Trauma·Rie AiharaErwin F Hirsch
Jul 13, 2002·Journal of the American College of Surgeons·Demetrios DemetriadesLinda Chan
Apr 22, 2003·AJR. American Journal of Roentgenology·C Craig BlackmorePeter Cummings
Jun 26, 2004·BJU International·Reynaldo G GomezJack McAninch
Aug 19, 2006·The Journal of Trauma·C Craig BlackmoreFrederick P Rivara
Dec 2, 2010·The Journal of Bone and Joint Surgery. British Volume·C A RansonR W Kerslake
Dec 30, 2015·The Journal of Trauma and Acute Care Surgery·Kristen M DelaneyJames A Meltzer
Citations
Sep 13, 2007·Nature Clinical Practice. Urology·Bryan B Voelzke, Jack W McAninch
Oct 22, 2008·Patient Safety in Surgery·Ryan P FinnanMary C McCarthy
May 22, 2008·AJR. American Journal of Roentgenology·Monique BrinkJohan G Blickman
Sep 21, 2013·Emergency Radiology·Bruce E LehnertMariam Moshiri
Mar 14, 2007·World Journal of Urology·Hossein TezvalMartin Burchardt
Apr 1, 2010·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Luke P H Leenen
Jan 21, 2015·BJU International·Darren J Bryk, Lee C Zhao
Aug 3, 2013·The Urologic Clinics of North America·James B McGeady, Benjamin N Breyer
May 18, 2012·Injury·Bradley D FiglerViraj Master
Nov 26, 2010·The Medical Clinics of North America·Jeremy B TonkinGerald H Jordan
Mar 18, 2008·Academic Radiology·Ruth C Carlos
Jun 12, 2016·Seminars in Roentgenology·Claire K SandstromKen F Linnau
Mar 24, 2016·Der Urologe. Ausg. A·S RauschJ Bedke
Jun 6, 2015·Radiologic Clinics of North America·Joel A GrossClaire K Sandstrom
May 29, 2015·BMC Musculoskeletal Disorders·Eli PeledM Bradford Henley
Oct 18, 2014·Emergency Radiology·Refky NicolaCary Siegel
May 27, 2014·The Journal of Urology·Allen F MoreyHunter Wessells
Jun 5, 2016·The Surgical Clinics of North America·Leonard N Zinman, Alex J Vanni
Oct 9, 2016·International Journal of Surgery Case Reports·Saud M AlfayezJesús Palencia
Dec 3, 2016·ANZ Journal of Surgery·Wilson ChoiEric Chung
Feb 9, 2018·BJU International·Nikita R BhattJohn F Quinlan
Jan 10, 2013·Korean journal of urology·Jung Hoon KimIn Ho Chang
Apr 27, 2010·Journal of Orthopaedic Trauma·William MinHenry Claude Sagi
Apr 29, 2016·JAAPA : Official Journal of the American Academy of Physician Assistants·Waqas ShuaibFaisal Khosa
Sep 9, 2019·Abdominal Radiology·Samir A HaroonChristina A LeBedis
Dec 5, 2017·The Medico-legal Journal·Siddhartha Das, Ritesh G Menezes
Oct 3, 2020·JBJS Reviews·Jillian M KazleyCory M Czajka
Nov 11, 2008·Clinical Radiology·C BentT Fotheringham