Adrenal gland laceration in adult trauma patients without severe concomitant abdominal organ injuries: Incidence, associated factors, and outcomes from a national trauma database study

Adrenal gland lacerations are sporadic but hostile injuries. The purpose of this investigation was to ascertain the prevalence, contributing variables, and outcomes of adrenal gland laceration in adult trauma victims. A retrospective cohort study analyzed data from 649,696 adult patients in the National Trauma Data Bank to compare patient characteristics, injury severity, and outcomes between patients with and without adrenal gland injuries. Multivariate logistic regression was used to control for confounding variables and identify significant associations. The analysis excluded patients with severe liver, spleen, kidney, and gallbladder injuries to focus on the impact of adrenal gland injuries, while minimizing the confounding effects of other severe abdominal organ injuries. The frequency of adrenal gland injuries was 0.35%, with 1820 (0.3%) patients having adrenal contusions and 310 (0.05%) having adrenal lacerations. Compared to patients without adrenal gland injuries, those with adrenal gland injuries were younger and had higher injury severity scores. Obesity and severe abdominal trauma were more prevalent in patients with adrenal lacerations and contusions. The most common injury mechanism was motor vehicle accident. Patients with adrenal lacerations had a higher prevalence of severe injuries to the kidney, spleen, liver, pancreas, small intestine, colon, and rectum than those with adrenal contusions and those without adrenal gland injuries. Patients with lacerations of the adrenal gland had a significantly higher in-hospital mortality rate. Although adrenal gland lacerations are scarce, they are associated with severe injuries and higher fatality rates in adult trauma patients. Early recognition and prompt management of adrenal gland injuries can improve the outcomes in this vulnerable population.