Injury - 2026-09-09 - Journal Article
Predictors of long-term quality of life following operative treatment of unstable pelvic ring injuries: A retrospective cohort study.
Ramesh P, Imran A, Nair MS, Devendra A, Chandramohan A, Dheenadhayalan J, Rajasekaran S
Topics
Key Takeaway
Poor reduction (>10 mm residual displacement) independently reduced EQ-5D index score by 0.22 points at mean 6.7-year follow-up after operative fixation of AO/OTA 61B/C pelvic ring injuries.
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Summary
This single-center retrospective cohort evaluated predictors of long-term HRQoL in 98 adults with operatively treated AO/OTA 61B/C pelvic ring injuries using EQ-5D-5L at mean 6.7 years. Multivariable regression identified poor reduction (>10 mm; β=-0.22, p<0.001) and polytrauma (β=-0.05, p=0.044) as the only independent predictors of worse quality of life. Fixation method and fracture classification subtype were not independently associated with outcome.
Key Limitation
Use of the Indian EQ-5D-5L value set limits generalizability to Western populations where utility weights differ, potentially misrepresenting the magnitude of HRQoL deficits.
Original Abstract
OBJECTIVES
To evaluate long-term health-related quality of life after operative treatment of unstable pelvic ring injuries and determine factors independently associated with outcome.
METHODS
A retrospective cohort study was conducted at a single Level I trauma center. Adult patients with AO/OTA 61B and 61 C pelvic ring injuries treated operatively between 2014 and 2018 with a minimum follow-up of five years were included. Health-related quality of life was assessed using the EQ-5D-5L (Indian value set). Associations between patient, injury, and treatment characteristics and EQ-5D index scores were evaluated using univariable and multivariable linear regression.
RESULTS
Ninety-eight patients were included (74% male; mean age, 41 ± 15 years) with a mean follow-up of 6.7 years. The mean EQ-5D index score was 0.87 ± 0.13. On univariable analysis, poor reduction, polytrauma, concomitant injuries, and postoperative complications were associated with lower EQ-5D scores, whereas combined and posterior fixation were associated with higher scores. On multivariable analysis, poor reduction (>10 mm; β = -0.22, 95% CI -0.29 to -0.15; p < 0.001) and polytrauma (β = -0.05, 95% CI -0.09-0.00; p = 0.044) remained independently associated with worse quality of life. Fixation method and AO/OTA fracture classification were not independently associated with outcome.
CONCLUSIONS
Poor reduction and polytrauma were independently associated with worse long-term quality of life after operative treatment of unstable pelvic ring injuries. Reduction quality was the only potentially modifiable factor independently associated with long-term outcome, supporting careful attention to fracture reduction during operative management.
LEVEL OF EVIDENCE
Prognostic Level IV.
LEVEL OF EVIDENCE
IV.
LEVEL OF CLINICAL CARE
Level I Tertiary trauma centre.