Work

In-hospital complications and treatment decision-making in osteoporotic pelvic ring fractures: The Role of the OF-Pelvis Score

Year: 2026

Type: article

Abstract: Introduction: Osteoporotic pelvic ring fractures (OPRFs) are associated with immobility-related complications and functional decline. The OF-Pelvis classification and score support treatment decision-making, but their relationship with in-hospital complications remains unclear. Research question: This study investigated whether the OF-Pelvis Score, fracture morphology, treatment modality, or patient-related factors predict in-hospital complications and short-term functional recovery. Material and methods: In this prospective multicentre cohort study, 390 patients with OPRFs treated at 14 German trauma centers were analysed. Fractures were classified according to the OF-Pelvis system, and score-based treatment recommendations were compared with actual treatment. Predictors of complications were assessed by logistic regression, and functional outcomes from treatment decision to discharge were analysed using repeated-measures general linear models. Results: Treatment information was available for 386 patients; 254 (66%) underwent surgery and 132 (34%) received conservative treatment. Complications occurred in 102 patients (26%). Treatment was concordant with the OF-Pelvis Score recommendation in 90% of cases, supporting its role in treatment decision-making. However, the score did not predict in-hospital complication risk. Age was the only independent predictor of complications, whereas treatment modality, baseline mobility, pain, and ASA classification were not independently associated with adverse events. Functional outcomes improved significantly during hospitalization. Discussion and conclusion: The OF-Pelvis Score reflected real-world treatment decisions but did not predict complication risk. Complications were primarily associated with patient-related factors, particularly age, supporting targeted geriatric co-management and complication prevention.

Source: Brain and Spine

DOI: 10.1016/j.bas.2026.107481