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Adrenal Injuries: Historical Facts and Modern Truths

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Abstract

Background

Prior to the advent of whole body computed tomography, injuries of the adrenal gland were almost exclusively identified on postmortem examinations and were associated with severe injury. Recent literature has continued to identify an association between adrenal injuries and high ISS. The purpose of this study was to assess the influence of adrenal trauma on ISS and mortality while controlling for potential confounding factors.

Methods

A 15-year retrospective review for all adrenal gland injuries from a Level 1 Trauma Center’s Trauma Registry was performed. Based on the characteristics of that patient population, the same Trauma Registry was then queried for case-matched patients, and the two groups compared to assess the influence of adrenal gland injuries on mortality.

Results

Seventy-two patients with adrenal injuries were identified and compared to 1026 case-matched patients. The adrenal gland injury was not a contributing factor in any of the study group mortalities. The mean ISS for the adrenal gland injured group was higher than the overall Registry ISS (18.7 vs 10.6) but almost identical to the ISS of patients case matched for abdominal injuries.

Conclusion

Case-matched analysis based on multiple clinical variables demonstrates that the ISS of patients with adrenal gland injuries were similar to the ISS of patients with other injuries to the abdominal region and were in fact associated with a 0.02% decrease in mortality.

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Authors and Affiliations

  1. Division of Trauma, Department of Surgery, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY, 11554, USA

    Jody C. DiGiacomo & L. D. George Angus

  2. Department of Health Professions, Hofstra University, Hempstead, NY, USA

    Edward Coffield

Authors
  1. Jody C. DiGiacomo
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  2. L. D. George Angus
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  3. Edward Coffield
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Corresponding author

Correspondence to Jody C. DiGiacomo.

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Conflict of interest

Dr. DiGiacomo and Dr. Coffield had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Dr. DiGiacomo has no potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations in regard to this submission, including design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Dr. Angus has no potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations in regard to this submission, including design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Dr. Coffield has no potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliations in regard to this submission, including design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

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DiGiacomo, J.C., Angus, L.D.G. & Coffield, E. Adrenal Injuries: Historical Facts and Modern Truths. World J Surg 41, 975–979 (2017). https://doi.org/10.1007/s00268-016-3840-3

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  • DOI: https://doi.org/10.1007/s00268-016-3840-3

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