Are adrenal injuries predictive of adrenal insufficiency in patients sustaining blunt trauma?

Eric T. Castaldo, Oscar D. Guillamondegui, Joseph Angelo Greco, Irene D. Feurer, Richard S. Miller, John A. Morris

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Adrenal insufficiency (AI) is an uncommon life-threatening development in trauma patients. The aim of this study was to determine if adrenal injury sustained during blunt trauma is associated with an increased risk of AI. A single-institution retrospective cohort review was performed over a 3-year period on all patients with blunt trauma requiring intensive care admission and mechanical ventilation for longer than 24 hours. Adrenal injuries were identified on admission CT scan. All patients with AI were identified as noted by practice management guidelines. Patients were stratified by Injury Severity Score (ISS) as less than 16, 16 to 25, and greater than 25 and relative risks were calculated. Multiple logistic regression was performed using age, race, sex, Glasgow Coma Scale, ISS, length of hospitalization, and adrenal injury as covariates with AI as the outcome of interest. A secondary analysis was then performed with adrenal injury classified as bilateral versus unilateral or no adrenal injury and relative risks were calculated for ISS strata. A total of 2072 patients were identified with 71 developing AI. Adrenal injuries were noted in 113 patients with eight subsequently developing AI. Multiple logistic regression model (P < 0.01) showed that age (P < 0.01) and increasing ISS (P = 0.02) were predictive of AI. Adrenal injury was not an independent predictor of AI (P = 0.12). After controlling for age and ISS, adrenal injury was not an independent predictor of the development of AI. Adrenal insufficiency should be considered with increasing injury severity and age in the intensive care setting after blunt trauma.

Original languageEnglish (US)
Pages (from-to)262-266
Number of pages5
JournalAmerican Surgeon
Volume74
Issue number3
StatePublished - Mar 1 2008

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Adrenal Insufficiency
Wounds and Injuries
Injury Severity Score
Logistic Models
Critical Care
Glasgow Coma Scale
Practice Management
Practice Guidelines
Artificial Respiration

ASJC Scopus subject areas

  • Surgery

Cite this

Castaldo, E. T., Guillamondegui, O. D., Greco, J. A., Feurer, I. D., Miller, R. S., & Morris, J. A. (2008). Are adrenal injuries predictive of adrenal insufficiency in patients sustaining blunt trauma? American Surgeon, 74(3), 262-266.

Are adrenal injuries predictive of adrenal insufficiency in patients sustaining blunt trauma? / Castaldo, Eric T.; Guillamondegui, Oscar D.; Greco, Joseph Angelo; Feurer, Irene D.; Miller, Richard S.; Morris, John A.

In: American Surgeon, Vol. 74, No. 3, 01.03.2008, p. 262-266.

Research output: Contribution to journalArticle

Castaldo, ET, Guillamondegui, OD, Greco, JA, Feurer, ID, Miller, RS & Morris, JA 2008, 'Are adrenal injuries predictive of adrenal insufficiency in patients sustaining blunt trauma?', American Surgeon, vol. 74, no. 3, pp. 262-266.
Castaldo ET, Guillamondegui OD, Greco JA, Feurer ID, Miller RS, Morris JA. Are adrenal injuries predictive of adrenal insufficiency in patients sustaining blunt trauma? American Surgeon. 2008 Mar 1;74(3):262-266.
Castaldo, Eric T. ; Guillamondegui, Oscar D. ; Greco, Joseph Angelo ; Feurer, Irene D. ; Miller, Richard S. ; Morris, John A. / Are adrenal injuries predictive of adrenal insufficiency in patients sustaining blunt trauma?. In: American Surgeon. 2008 ; Vol. 74, No. 3. pp. 262-266.
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