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Blunt Adrenal Injury is Not Associated With Worse Outcomes in Adult Trauma Patients.
Park, Flora; Grigorian, Areg; Swentek, Lourdes; Kuza, Catherine; Kong, Allen; Russell, Dylan; Nahmias, Jeffry.
Afiliación
  • Park F; School of Medicine, University of California, Irvine, Irvine, California.
  • Grigorian A; Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California.
  • Swentek L; Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California.
  • Kuza C; Department of Anesthesiology, Keck School of Medicine of the University of Southern California, Los Angeles, California.
  • Kong A; Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California.
  • Russell D; Department of Surgery, Tripler Army Medical Center, Honolulu, Hawaii.
  • Nahmias J; Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California. Electronic address: jnahmias@hs.uci.edu.
J Surg Res ; 296: 115-122, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38277946
ABSTRACT

INTRODUCTION:

Blunt adrenal injury is rare. Given production of hormones including catecholamines, adrenal injury may lead to worse outcomes. However, there is a paucity of literature on this topic. As such, we compared blunt trauma patients (BTPs) with and without adrenal injuries, hypothesizing similar mortality and complications between cohorts.

METHODS:

The 2017-2019 Trauma Quality Improvement Program database was queried for adult (≥18-year-old) BTPs. Patients with penetrating trauma, traumatic brain injury, severe thoracic injury, or who were transferred from another hospital were excluded. Patients with adrenal injury were compared to those without using a 12 propensity score model. Matched variables included patient age, comorbidities, vitals on admission and concomitant injuries (i.e., liver, spleen, kidney, pancreas, and hollow viscus). Univariable logistic regression was then performed for associated risk of mortality.

RESULTS:

2287 (0.2%) BTPs had an adrenal injury, with 1470 patients with adrenal injury matched to 2940 without adrenal injury. The rate of all complications including sepsis (0.1% versus 0.0%) was similar between cohorts (all P > 0.05). Patients with adrenal injury had a lower rate of mortality (0.1% versus 0.6%, P = 0.035) but increased length of stay (4 [3-6] versus 3 [2-5] days, P = 0.002). However, there was no difference in associated risk of mortality for patients with and without adrenal injury (odds ratio = 0.234; confidence interval = 0.54-1.015; P = 0.052).

CONCLUSIONS:

Blunt adrenal injury occurred in <1% of patients. After propensity matching, there was a similar associated rate of complications but longer hospital length of stay for patients with adrenal injury. Adrenal injury was not associated with an increased risk of mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos Torácicos / Heridas no Penetrantes / Heridas Penetrantes / Lesiones Traumáticas del Encéfalo Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Humans Idioma: En Revista: J Surg Res Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos Torácicos / Heridas no Penetrantes / Heridas Penetrantes / Lesiones Traumáticas del Encéfalo Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Humans Idioma: En Revista: J Surg Res Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos