From surveillance to surgery: The delayed implications of non-operative and operative management of pancreatic injuries

Qaidar Alizai, Tanya Anand, Sai Krishna Bhogadi, Adam Nelson, Hamidreza Hosseinpour, Collin Stewart, Audrey L. Spencer, Christina Colosimo, Michael Ditillo, Bellal Joseph

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Our study compares the delayed outcomes of operative versus nonoperative management of pancreatic injuries. Methods: We analyzed the 2017 Nationwide Readmissions Database on adult (≥18 years) trauma patients with pancreatic injuries. Patients who died on index admission were excluded. Patients were stratified into operative (OP) and non-operative (NOP) groups and compared for outcomes within 90 days of discharge. Multivariable regression analyses were performed. Results: We identified 1553 patients (NOP ​= ​1092; OP ​= ​461). The Mean (SD) age was 39 (17.0) years, 31% of patients were female, and 77% had blunt injuries. Median ISS was 17 [9–25] and 74% had concomitant non-pancreatic intraabdominal injuries. On multivariable analysis, operative management was independently associated with increased odds of 90-day readmissions (aOR ​= ​1.47; p ​= ​0.03), intraabdominal abscesses (aOR ​= ​2.7; p ​< ​0.01), pancreatic pseudocyst (aOR ​= ​2.4; p ​= ​0.04), and need for percutaneous or endoscopic management (aOR ​= ​5.8; p ​< ​0.001). Conclusion: Operative management of pancreatic injuries is associated with higher rates of delayed complications compared to non-operative management. Surgically treated pancreatic trauma patients may need close surveillance even after discharge.

Original languageEnglish (US)
Pages (from-to)682-687
Number of pages6
JournalAmerican journal of surgery
Volume226
Issue number5
DOIs
StatePublished - Nov 2023

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'From surveillance to surgery: The delayed implications of non-operative and operative management of pancreatic injuries'. Together they form a unique fingerprint.

Cite this