MP18-08 ADRENAL INJURIES: A NATIONAL TRAUMA DATA BANK ANALYSIS

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Ureter, Bladder, External Genitalia and Urotrauma I1 Apr 2015MP18-08 ADRENAL INJURIES: A NATIONAL TRAUMA DATA BANK ANALYSIS Jairam R. Eswara, Valary T. Raup, Julio Geminiani, Joel Vetter, and Steven B. Brandes Jairam R. EswaraJairam R. Eswara More articles by this author , Valary T. RaupValary T. Raup More articles by this author , Julio GeminianiJulio Geminiani More articles by this author , Joel VetterJoel Vetter More articles by this author , and Steven B. BrandesSteven B. Brandes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1040AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Adrenal trauma is extremely rare and current literature is lacking in data from large case series. In this study, we analyze adrenal injuries using the National Trauma Data Bank (NTDB). METHODS We performed a retrospective analysis of the NTDB from the years 2007–2011. Patient demographics, Injury Severity Score (ISS), mechanism of injury, blunt versus penetrating trauma, associated injuries and hypovolemic shock were assessed. Multivariable models were used to determine associations with outcomes such as need for surgery, type of surgery mean length of stay, need for ICU, and death. RESULTS Of the 1,766,606 trauma cases in the data set, 8683 were identified as involving one or both adrenal glands. There were 7835 blunt and 663 penetrating injuries, and 184 of these injures were isolated to the adrenal glands. Of the 8683 adrenal injuries, 80 (0.9%) required surgery. However, none of the 184 isolated adrenal injures required surgery (p=0.42). Factors associated with isolated adrenal injury include lower ISS (p<0.001), younger age (p<0.001), and penetrating injury (p<0.001). No isolated adrenal injuries were associated with death (12% vs. 0%, p<0.0001). The most common associated organ injuries were ribs (50.9%), thoracic (50.0%), liver (41.6%), vertebrae (30.9%), kidney (27.8%), and spleen (22.0%). Logistic regression showed that injures to the thorax (p=0.0014) and multiple abdominal injuries (p<0.001) were associated with a lower rate of undergoing adrenal surgery. Higher ISS score (p=0.007), penetrating injury (p<0.001), race (Black) (p=0.029) and concurrent injuries to the spleen (p<0.001) and intestines (p=0.016) were associated with a higher likelihood of requiring adrenal surgery. Older age (p<0.001), higher ISS score (p<0.001), race (Black, Other) (p=0.03, p=0.02), penetrating injuries (p<0.001) and injuries to the aorta/vena cava (p=0.008), vessels (p=0.001), thorax (p=0.03), ribs (p=0.005), stomach (p=0.02), liver (p=0.03), multiple abdominal injuries (p=0.002), and brain/spinal cord (p<0.001) were associated with a higher mortality rate. CONCLUSIONS Adrenal injuries are rare, comprising 0.49% of all traumatic injuries. In our database, isolated adrenal injuries were not fatal and did not require surgery. Younger age, race (Black), higher ISS score, penetrating injury, and concurrent injuries to the spleen/intestines were associated with a higher likelihood of requiring an adrenalectomy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e208 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jairam R. Eswara More articles by this author Valary T. Raup More articles by this author Julio Geminiani More articles by this author Joel Vetter More articles by this author Steven B. Brandes More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...