3791 Rising burden of pelvic fracture: a need for prompt identification to minimise harm

Abstract Introduction Pelvic fractures are a common fragility fracture, associated with adverse clinical outcome but often under recognised. There is a wide range of incidence 6.9–78.6/100,000/year being reported in the UK. There is a paucity of studies describing incidence and adverse outcomes including mortality and re-fracture risk. The objective of this study is to measure incidence of fragility fracture for the population of Gwent (592,000), compare baseline characteristics with all fragility fractures and measure clinical outcomes of pelvic fractures. Methods All fragility fracture patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) between January 2022 and June 2024 were reviewed retrospectively. The clinical outcomes for pelvic fracture including re-fracture and mortality were analysed at 12 months. Results A total of 5310 fragility fracture patients were observed for 2.5 years and 5% (n = 263) had pelvic fracture. The incidence of pelvic fracture over 2.5 years was 17.7/100,000/year. However, due to improved fragility fracture case identification, incidence for the year 2024 was 36.6/100,000/year. 52.1% (n = 137) patients with pelvis fracture had previous fragility fracture. Mean age of all pelvic fracture patients (n = 263) was 83.7 ± 8.4, whereas mean age for all the fragility fracture patients seen by AB-FLS (n = 5310) was 79.7 ± 8.7, the difference being statistically significant (p < 0.001). Females were 81.7% (n = 215) which was higher as compared to all females seen by AB-FLS were 77.8% (n = 4136), but this was not significant on difference between proportions test, p = 0.18. Only 5.3% patients were admitted from care home (n = 14) which was comparable to all the patients seen by AB-FLS (5.5%, n = 294) and not significant on difference between proportions test, p = 0.97. Moreover, 60.1% (n = 158) pelvic fracture patients were hospitalised which was higher than all fragility fracture admitted to hospital (48.4%, n = 2570) and was a significant difference between proportions test, p = 0.004 61.2% (n = 161) were started on osteoporosis treatment. 23.6% (n = 62) pelvic fracture patients died at 12 months. Although 85.2% (n = 224) had no fracture, 14.8% (n = 39) had re-fracture at 12 months. 11.4% (n = 30) re-fractured at 12-months involving hip, wrist, spine, humerus or pelvis. 2.7% (n = 7) of the total pelvic fracture had hip fracture within 12 months. Conclusion Over 60% patients with pelvis fracture required inpatient care which was significantly higher in comparison to all fragility fracture admissions (48%). Pelvic fractures were associated with high one-year mortality (23.6%). More research is needed to close this gap, so we can better understand the impact of pelvic fractures on health services.