Traumatic Non-pancreatic Causes of Hyperlipasaemia: A Retrospective Cohort Study

Abstract Background: Traumatic pancreatic injury, though infrequent, poses diagnostic challenges with delayed recognition contributing to increased morbidity and mortality. Serum lipase and amylase are standard pancreatic injury markers, yet hyperlipasaemia can arise from non-pancreatic aetiologies in polytrauma. This study aimed to characterize non-pancreatic causes of hyperlipasaemia in polytrauma patients. Materials and Methods: A descriptive cohort study was conducted on adult polytrauma patients admitted between January 2016 and December 2022, with measured lipase levels. Patients with confirmed pancreatic injuries were excluded. Group I comprised patients with normal lipase levels, while Group II exhibited hyperlipasaemia. Statistical analysis assessed associations between hyperlipasaemia and clinical variables. Results: Of 130 patients, 86.2% were male, with a mean age of 28.05 ± 9.82 years. Blunt trauma (87.7%) and motor vehicle accidents (65.4%) were predominant. Hyperlipasaemia was observed in 58.5% of patients. Significant associations were found between hyperlipasaemia and elevated alanine aminotransferase, aspartate aminotransferase levels, abdominal and pelvic injuries ( P < 0.05), and prolonged hospital stays. Multivariate logistic regression identified negative focused assessment with sonography for trauma (FAST) and abdominal/pelvic involvement as independent predictors of hyperlipasaemia. Conclusion: Hyperlipasaemia in polytrauma patients frequently occurs in the absence of pancreatic injury. Associated risk factors include concomitant abdominal and pelvic trauma, negative FAST results, and elevated hepatic transaminases. These findings underscore the necessity of interpreting hyperlipasaemia within the broader clinical context of polytrauma, rather than solely as a marker of pancreatic injury.