Predictors of laparotomy and mortality in polytrauma patients with pelvic fractures.

The decision to perform laporotomy in blunt trauma patients is often difficult. One of the factors affecting this decision is the presence of associated pelvic fractures. Hypotension, low hemoglobin levels and abnormal physical examinations may all be present with or without important associated abdominal trauma requiring laparotomy. However, once laparotomy is required, failure to perform this procedure or delaying its performance could affect morbidity and mortality.1–3 Tien and colleagues4,5 reported that preventable deaths among polytrauma patients are largely due to delay in controlling hemorrhage. Furthermore, once hemorrhage is controlled, end points of resuscitation should be examined clinically with a view to restricting transfusion and minimizing the complications of aggressive transfusion. To guide the decision for laparotomy in patients with pelvic fractures and hopefully decrease mortality, we retrospectively assessed mortality in severely injured polytrauma patients with pelvic fractures who underwent laparotomy, and we compared their outcomes with those of patients who did not undergo laparotomy. We also reviewed and reported laparotomy findings.