Outcomes Associated With Pelvic Binder Use in Hypotensive Patients With Unstable Pelvic Fractures
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Pelvic binders are employed with the intent to limit hemorrhage and improve outcomes. This study aimed to evaluate whether their use is associated with a reduction in mortality and interventions intended for hemorrhage control, as well as if there is a potential risk of adverse outcomes, in hypotensive patients with unstable pelvic fractures. Methods The ACS TQIP database from 2016-2021 was used to identify all adult patients who suffered an unstable pelvic fracture (Tile B or C) due to blunt trauma and were hypotensive (SBP <90 mmHg) on admission. To compare the effectiveness of pelvic binder use vs non-use, Poisson regression models and a quantile regression model were used to determine the association between pelvic binder use and outcomes. Results A total of 8311 patients were included in the analysis, of whom 5.3% (N = 441) received a pelvic binder. After adjusting for confounders, the use of a pelvic binder was not associated with a reduction in 24-hour or in-hospital mortality, nor the need for laparotomy/pelvic packing for hemorrhage control. Pelvic binder use was associated with a 26% increased probability of pelvic angioembolization ( P = .005), a 59% increased risk of decubitus ulcers ( P = .018), and a 34% increased risk of lower urinary tract injury ( P < .001). Patients who received a pelvic binder also received a median of 1.44 more units of PRBC within the first 4 hours of admission ( P < .001). Conclusion Despite selecting for a population that could be most expected to benefit from their application, the use of pelvic binders in hypotensive patients with unstable pelvic fractures was not associated with a reduction in mortality, units of PRBC transfused, nor the need for surgery and angioembolization for hemorrhage control.
Source: The American Surgeon
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,150
OpenAlex ID: W7204195056