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Are traumatic bilateral adrenal injuries associated with higher morbidity and mortality?-A prospective observational study

Overview of attention for article published in Journal of Trauma Management & Outcomes, August 2015
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Title
Are traumatic bilateral adrenal injuries associated with higher morbidity and mortality?-A prospective observational study
Published in
Journal of Trauma Management & Outcomes, August 2015
DOI 10.1186/s13032-015-0026-1
Pubmed ID
Authors

Ananya Panda, Atin Kumar, Shivanand Gamanagatti, Ashu Seith Bhalla, Raju Sharma, Subodh Kumar, Biplab Mishra

Abstract

Traumatic bilateral adrenal injuries are uncommon. Adrenal injuries are overall associated with worse outcome than non-adrenal injuries. However, direct comparative evidence between unilateral and bilateral adrenal injuries is unavailable in literature. This study aims to investigate clinical significance of bilateral adrenal hematomas in terms of injury severity, morbidity and mortality. All blunt trauma abdomen patients with adrenal gland involvement on initial CECT scans of abdomen presenting to our Level 1 trauma centre over 21 months were prospectively included and followed-up. Patients were divided into unilateral and bilateral adrenal hematoma groups. For all patients, mechanism of injury, initial pulse, blood pressure, respiratory rate, Glasgow Coma Scale (GCS) scores, Injury Severity Score (ISS), New Injury Severity Score (NISS), length of ICU stay (LOI), length of hospital stay (LOS), total blood products (TBP) received were recorded. Final outcome was noted as complete recovery; discharge with poor prognosis and death. Quantitative parameters between both groups were compared using appropriate statistical tests and P < 0.05 was considered significant. Forty seven patients were detected to have adrenal hematomas, 34 with unilateral (30 right and 4 left) and 13 with bilateral involvement. An oval mass replacing the gland was the most common appearance of injury (35/60) and periadrenal fat stranding was most common associated finding (47/60). Patients with bilateral adrenal hematoma had significantly lower GCS (13 vs 15, P < 0.01), ISS (38 vs 22, P < 0.01), NISS (47 vs 21, P < 0.01), LOI as proportion of LOS (91.7 % vs 10.5 %, P = 0.01) and TBP received (10 vs 4 units, P < 0.05). Outcome in bilateral group was comparatively worse with higher proportion of deaths or discharge with poor prognosis (P = 0.000). Patients with bilateral adrenal injury are associated with higher injury severity, morbidity and mortality compared to unilateral adrenal injury.

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Mendeley readers

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Geographical breakdown

Country Count As %
Unknown 8 100%

Demographic breakdown

Readers by professional status Count As %
Other 3 38%
Student > Master 2 25%
Student > Postgraduate 1 13%
Student > Ph. D. Student 1 13%
Professor > Associate Professor 1 13%
Other 0 0%
Readers by discipline Count As %
Medicine and Dentistry 6 75%
Computer Science 1 13%
Biochemistry, Genetics and Molecular Biology 1 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 August 2015.
All research outputs
#10,931,472
of 13,754,665 outputs
Outputs from Journal of Trauma Management & Outcomes
#43
of 51 outputs
Outputs of similar age
#160,465
of 234,442 outputs
Outputs of similar age from Journal of Trauma Management & Outcomes
#1
of 1 outputs
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