{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T17:06:27Z","timestamp":1774371987324,"version":"3.50.1"},"reference-count":32,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Patients with severe pelvic fractures carry a greater risk of severe bleeding, and pelvic compression devices (PCCD) are used to stabilize the pelvis on the pre-hospital scene. The aim of this study was to describe the use of PCCD in the pre-hospital setting on a nationwide scale (Switzerland) and determine the sensitivity, specificity and rates of over- and under-triage of the current application practices. The secondary objective was to identify pre-hospital factors associated with unstable pelvic fractures. Methods: Retrospective cross-sectional study using anonymized patient data (1 January 2015\u201331 December 2020) from the Swiss Trauma Registry (STR). Based on AIS scores, patients were assigned a unique principal diagnosis among three categories (unstable pelvic fracture\u2014stable pelvic fracture\u2014other) and assessed for use or not of PCCD. Secondarily, patient characteristics, initial pre-hospital vital signs, means of pre-hospital transport and trauma mechanism were also extracted from the database. Results: 2790 patients were included for analysis. A PCCD was used in 387 (13.9%) patients. In the PCCD group, 176 (45.5%) had an unstable pelvic fracture, 52 (13.4%) a stable pelvic fracture and 159 (41.1%) an injury unrelated to the pelvic region. In the group who did not receive a PCCD, 214 (8.9%) had an unstable pelvic fracture, 182 (7.6%) a stable pelvic fracture and 2007 (83.5%) an injury unrelated to the pelvic region. The nationwide sensitivity of PCCD application was 45.1% (95% CI 40.1\u201350.2), the specificity 91.2% (95% CI 90\u201392.3), with both over- and under-triage rates of 55%. The prevalence of unstable fractures in our population was 14% (390\/2790). We identified female sex, younger age, lower systolic blood pressure, higher shock index, pedestrian hit and fall \u22653 m as possible risk factors for an unstable pelvic fracture. Conclusions: Our results demonstrate a nationwide both over- and under-triage rate of 55% for out-of-hospital PCCD application. Female gender, younger age, lower blood pressure, higher shock index, pedestrian hit and fall &gt;3 m are possible risk factors for unstable pelvic fracture, but it remains unclear if those parameters are relevant clinically to perform pre-hospital triage.<\/jats:p>","DOI":"10.3390\/jcm12175509","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T08:42:20Z","timestamp":1692952940000},"page":"5509","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Performance Assessment of Out-of-Hospital Use of Pelvic Circumferential Compression Devices for Severely Injured Patients in Switzerland: A Nationwide Retrospective Cross-Sectional Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Lionel","family":"Balet","sequence":"first","affiliation":[{"name":"Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois-Xavier","family":"Ageron","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-5909","authenticated-orcid":false,"given":"Mathieu","family":"Pasquier","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0905-2299","authenticated-orcid":false,"given":"Tobias","family":"Zingg","sequence":"additional","affiliation":[{"name":"Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"The Swiss Trauma Registry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"ref_1","unstructured":"Centers for Disease Control and Prevention NC for I and P (2021, June 14). 10 Leading Causes of Death, United States 2019, Available online: https:\/\/webappa.cdc.gov\/sasweb\/ncipc\/leadcause.html."},{"key":"ref_2","unstructured":"Swiss Federal Statistical Office (2023, August 20). 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