Bramos et al identified factors associated with significant bleeding in a trauma patient with a stable pelvic fracture. These can help identify a patient who may require blood transfusion or an intervention to control the bleeding. The authors are from Massachusetts General Hospital and Harvard Medical School in Boston.


Significant bleeding was defined as one or both of the following:

(1) a need for blood transfusion

(2) intervention to control bleeding within the first 24 hours after hospital admission


A stable pelvic fracture does not require operative fixation and is usually associated with a low risk of significant bleeding. Bleeding from the pelvic fracture should be suspected when there is evidence of internal hemrrhage that cannot otherwise be explained.


Predictors of significant bleeding in a patient with a stable pelvic fracture:

(1) admission hematocrit <= 30%

(2) pelvic hematoma present on imaging studies

(3) admission systolic blood pressuer <= 90 mm Hg


A patient with a stable pelvic fracture, evidence of bleeding and one or more predictors should be monitored more closely and treated more aggressively.


To read more or access our algorithms and calculators, please log in or register.