Adrenal gland injury is a rare finding after blunt thoracoabdominal trauma. The diagnosis can
be accurately made with CT scan in stable patients, whilst in unstable patients, the
detection can often be made during surgery, in the post-operative setting or postmortem.
Short-term outcomes of blunt adrenal gland injury (BAGI) described in literature are
contradictory. Studies reported BAGI as a high mortality risk injury. On the other hand,
according to further reports, the presence of a BAGI is not considered a marker of severe
injury or associated with an increased mortality rate.
Evidences the from a large multicenter cohort of selected trauma patients are lacking.
The study hypothesis is that BAGI is related to patients with higher trauma severity and
worse overall outcome. By exploring the clinical burden related to BAGI the investigators aim
to determine if this is related to the anatomical location of the injured organ or if in
addition an underlying undisclosed pato-physiological mechanism is present. The
investigatorspropose an international multicenter analysis on the epidemiology and the burden
of BAGI in the context of major trauma, exploring differences between BAGI and non-BAGI
patients.
Primary endpoint:
• Relationship between trauma severity (Injury Severity Score) of thoraco-abdominal trauma
patients with BAGI versus torso trauma patients without BAGI
Secondary endpoint:
• Organ Injury Scale of the blunt adrenal trauma(OIS), overall survival, ICU length of stay,
overall length of stay
Methods:
Patients will be enrolled according to the reported criteria. The following variables will be
considered: - Demographic (age, sex, comorbidities) - Mechanism of trauma - Trauma bay and
surgical management - Trauma severity (ISS, NISS, OIS, AIS) - Need for ventilation (Y/N,
timing) - Data on vasoactive support - Post trauma clinical and laboratory parameters -
Mortality - Length of stay (ICU, hospital) All information of patients will be extracted from
our dedicated Trauma Registry and personal informations will be removed according to data
anonymization, and collected in an electronic database.
Data will be reported in accordance with Strengthening the Reporting of Observational studies
in Epidemiology guidelines (STROBE) for observational studies.
Statistical analysis A 1:1 propensity score matching analysis will be performed based on sex,
setting of the trauma, trauma mechanism, age, ASA classification, intentionality of the
trauma, Glasgow coma scale and Revised Trauma Score. Following the propensity score matching
patients included with and without BAGI will be compared using χ2 test for categorical
variables and t-student test or Mann-Whitney test according to sample distribution for
continuous variables