{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:29:53Z","timestamp":1793042993319,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: Patients with unstable pelvic fractures typically die of hemorrhagic shock, whereas those with open pelvic fractures (OPF) more commonly die of pelvic infections (PIs) and pelvic sepsis (PS). We examined the clinical outcomes of PI in patients with OPFs. Methods: Patients with OPFs treated at our hospital between March 2016 and February 2023 were retrospectively reviewed. Factors associated with PI were identified using logistic regression analysis. Results: A total of 44 patients with OPFs were included, of whom 22 developed PIs. The number of patients with Gustilo\u2013Anderson grade III was higher in the PI group than in the non-PI group (n = 18 vs. 8, p = 0.008). Similarly, anorectal injury was more frequent in the PI group than in the non-PI group (n = 15 vs. 3, p = 0.001). Multivariate logistic regression identified age (odds ratio 1.082 [95% confidence interval 1.020\u20131.148], p = 0.009), serum lactate level (1.319 [0.992\u20131.755], p = 0.018), presence of Gustilo\u2013Anderson grade III (7.467 [0.987\u201356.517], p = 0.052), and anorectal injury (36.468 [3.107\u2013427.991], p = 0.004) as independent risk factors for PI. Hospital length of stay, overall medical costs, and number of surgeries were 2.8 (84.0 vs. 30.5 days, p = 0.002), 2.9 (95,812 vs. 33,224 USD, p = 0.001), and 2.9 (13.0 vs. 4.5, p &lt; 0.001) times higher in the PI group than in the non-PI group, respectively. Conclusions: Age and anorectal injury were significantly associated with pelvic infection. Serum lactate level and Gustilo\u2013Anderson grade III injury showed possible associations, although statistical precision was limited. PIs were associated with high medical costs. Early wound management, precise antibiotic therapy, and multidisciplinary approaches are necessary to treat PIs.<\/jats:p>","DOI":"10.3390\/healthcare14101328","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T12:46:55Z","timestamp":1778676415000},"page":"1328","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors, Clinical Outcomes, and Medical Costs of Pelvic Infection After Open Pelvic Fractures: A 7-Year Retrospective Observational Study at a Single Trauma Center"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-4371","authenticated-orcid":false,"given":"Donghwan","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3104-4495","authenticated-orcid":false,"given":"Jungsub","family":"So","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Tae","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Keun","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoungwon","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon 16499, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/S0030-5898(05)70293-5","article-title":"Open pelvic fractures. A multicenter retrospective analysis","volume":"28","author":"Jones","year":"1997","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.amjsurg.2005.05.050","article-title":"The outcome of open pelvic fractures in the modern era","volume":"190","author":"Dente","year":"2005","journal-title":"Am. J. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2309499020939830","DOI":"10.1177\/2309499020939830","article-title":"Clinical features and risk factors for mortality in patients with open pelvic fracture: A retrospective study of 46 cases","volume":"28","author":"Guo","year":"2020","journal-title":"J. Orthop. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1097\/00005373-197709000-00005","article-title":"The deep perineal laceration-an injury frequently associated with open pelvic fractures: A need for aggressive surgical management. A report of 12 cases and review of the literature","volume":"17","author":"Maull","year":"1977","journal-title":"J. Trauma"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1097\/TA.0b013e3182827496","article-title":"The Jones-Powell Classification of open pelvic fractures: A multicenter study evaluating mortality rates","volume":"74","author":"Cannada","year":"2013","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"263","DOI":"10.4055\/cios.2013.5.4.263","article-title":"Treatment outcomes of open pelvic fractures associated with extensive perineal injuries","volume":"5","author":"Hasankhani","year":"2013","journal-title":"Clin. Orthop. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00068-015-0496-x","article-title":"Sepsis in fatal pelvic trauma patients: Report from a level-1 Indian Trauma Centre","volume":"42","author":"Lalwani","year":"2016","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1089\/sur.2017.083","article-title":"Factors of pelvic infection and death in patients with open pelvic fractures and rectal injuries","volume":"18","author":"Song","year":"2017","journal-title":"Surg. Infect."},{"key":"ref_9","first-page":"550","article-title":"Clinical treatment of open pelvic fractures associated with perineal injury","volume":"26","author":"Wei","year":"2012","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"ref_10","first-page":"1548\u20131554","article-title":"Sepsis caused by peripelvic soft tissue infections in critically injured patients with multiple injuries and unstable pelvic fracture","volume":"66","author":"Kataoka","year":"2009","journal-title":"J. Trauma"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00423-006-0090-0","article-title":"The use of vacuum assisted closure (VAC) in soft tissue injuries after high energy pelvic trauma","volume":"392","author":"Labler","year":"2007","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.injury.2004.05.029","article-title":"Open pelvic fractures: Epidemiology, current concepts of management and outcome","volume":"36","author":"Grotz","year":"2005","journal-title":"Injury"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1001\/archsurg.133.3.281","article-title":"Open pelvic fracture and fecal diversion","volume":"133","author":"Woods","year":"1998","journal-title":"Arch. Surg."},{"key":"ref_14","first-page":"1275","article-title":"New therapeutic strategy of open pelvic fracture associated with rectal injury in 43 patients over 60 years of age","volume":"49","author":"Tsugawa","year":"2002","journal-title":"Hepato-Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1097\/01.ta.0000197615.31553.1e","article-title":"Does colostomy prevent infection in open blunt pelvic fractures? A systematic review","volume":"60","author":"Lunsjo","year":"2006","journal-title":"J. Trauma"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.injury.2011.12.002","article-title":"Prevention of pelvic sepsis in major open pelviperineal injury","volume":"43","author":"Govaert","year":"2012","journal-title":"Injury"},{"key":"ref_17","first-page":"e280\u2013282","article-title":"The role of diverting colostomy in traumatic blunt open pelvic fractures","volume":"83","author":"Fitzgerald","year":"2017","journal-title":"Am. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.injury.2023.02.006","article-title":"Management of open pelvic ring injuries","volume":"54","author":"Roszman","year":"2023","journal-title":"Injury"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1007\/s00264-023-05719-8","article-title":"Surgical site infections after stabilization of pelvic ring injuries: A retrospective analysis of risk factors and a meta-analysis of similar studies","volume":"47","author":"Whitley","year":"2023","journal-title":"Int. Orthop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"772","DOI":"10.2174\/1874325001610010772","article-title":"Open pelvic fractures: Review of 30 cases","volume":"10","author":"Giordano","year":"2016","journal-title":"Open Orthop. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Watkins, R.J., and Hsu, J.M. (2020). The road to survival for haemodynamically unstable patients with open pelvic fractures. Front. Surg., 7.","DOI":"10.3389\/fsurg.2020.00058"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13049-016-0220-9","article-title":"Predictors of early versus late mortality in pelvic trauma patients","volume":"24","author":"Wang","year":"2016","journal-title":"Scand. J. Trauma Resusc. Emerg. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.jcot.2020.08.017","article-title":"Risk factors for complications and in-hospital mortality: An analysis of 19,834 open pelvic ring fractures","volume":"11","author":"Frane","year":"2020","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_24","first-page":"592","article-title":"Age-related differences in mechanism, cause, and location of trauma deaths","volume":"77","author":"Meisler","year":"2011","journal-title":"Minerva Anestesiol."},{"key":"ref_25","first-page":"135","article-title":"The impact of premorbid conditions on temporal pattern and location of adult blunt trauma hospital deaths","volume":"63","author":"Bamvita","year":"2007","journal-title":"J. Trauma"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/0020-1383(91)90073-N","article-title":"Injury scoring by TRISS and ISS\/age","volume":"22","author":"Bull","year":"1991","journal-title":"Injury"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.injury.2011.01.032","article-title":"Management and outcome of open pelvic fractures: A retrospective study of 41 cases","volume":"42","author":"Dong","year":"2011","journal-title":"Injury"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s13018-018-0793-2","article-title":"Open pelvic fracture: The killing fracture?","volume":"13","author":"Hermans","year":"2018","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1083\u20131090","DOI":"10.1016\/j.amjsurg.2014.09.002","article-title":"Pelvic ring fractures: Has mortality improved following the implementation of damage control resuscitation?","volume":"208","author":"Fitzgerald","year":"2014","journal-title":"Am. J. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e000136","DOI":"10.1136\/tsaco-2017-000136","article-title":"Current outcomes of blunt open pelvic fractures: How modern advances in trauma care may decrease mortality","volume":"2","author":"Siada","year":"2017","journal-title":"Trauma Surg. Acute Care Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s00068-009-9094-0","article-title":"Pelvic fracture and risk factors for mortality: A population-based study in Taiwan","volume":"36","author":"Chien","year":"2010","journal-title":"Eur. J. Trauma Emerg. Surg."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1328\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T13:57:11Z","timestamp":1778680631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/14\/10\/1328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["healthcare14101328"],"URL":"https:\/\/doi.org\/10.3390\/healthcare14101328","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]}}}