Impact of Concomitant Traumatic Pancreatic and Colon Injuries on Outcomes

• Published in: The American surgeon 2024-09, Vol.90 (9), p.2217-2221
• Main Authors: Lewis, Richard H., Jacome, Tomas, Dooley, Danielle, Carr, Brian, Magnotti, Louis J.
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Abscess - epidemiology; Abdominal Abscess - etiology; Abdominal Injuries - complications; Abdominal Injuries - surgery; Abscesses; Adult; Blood pressure; Colon; Colon - injuries; Erythrocyte Transfusion; Erythrocytes; Failure; Female; Head injuries; Humans; Impact analysis; Injuries; Injury analysis; Injury Severity Score; Logistic Models; Male; Middle Aged; Morbidity; Mortality; Multiple Trauma - complications; Ostomy; Pancreas; Pancreas - injuries; Patients; Regression analysis; Retrospective Studies; Statistical analysis; Sutures; Trauma; Treatment Outcome; Variance analysis; Wounds, Penetrating - complications; Wounds, Penetrating - surgery; Young Adult
• ISSN: 0003-1348; 1555-9823; 1555-9823
• DOI: 10.1177/00031348241256074

Background Colon and pancreatic injuries have both long been independently associated with intraabdominal infectious complications in trauma patients. The goal of this study was to evaluate the impact of concomitant pancreatic injury on outcomes in patients with traumatic colon injuries. Methods Consecutive patients over a 3-year period who underwent operative management of colon injuries were identified. Patient characteristics, severity of injury and shock, presence and grade of pancreatic injury, and intraoperative packed red blood cell (PRBC) transfusions were recorded. Outcomes including intraabdominal abscess formation and suture line failure were collected and compared. Multivariable logistic regression analysis was then performed to determine the impact of concomitant pancreatic injury on intraabdominal abscess formation. Results 243 patients with traumatic colon injuries were identified. 17 of these also had pancreatic injuries. Patients with combined colon and pancreatic injuries were clinically similar to those with isolated colon injuries with respect to age, gender, penetrating mechanism of injury, admission lactate, ISS, suture line failure, and admission systolic blood pressure. Both intraabdominal abscess rates (88.2% vs 29.6%, P < .001) and intraoperative PRBC transfusions (8 vs 1 units, P = .004) were higher in the combined pancreatic and colon injury group. Multivariable logistic regression identified both intraoperative PRBC transfusions (odds ratio, 1.09; 95% confidence interval, 1.04-1.15; P < .001) and concomitant pancreatic injury (odds ratio, 14.8; 95% confidence interval, 3.92-96.87; P < .001) as independent predictors of intraabdominal abscess formation. Discussion Both intraoperative PRBC transfusions and presence of concomitant pancreatic injury are independent predictors of intraabdominal abscess formation in patients with traumatic colon injuries.