title: Pancreatic injury in 284 patients with severe abdominal trauma: outcome, course, and treatment algorithm.
abstract: OBJECTIVE
  The relevance of pancreatic trauma in severely injured patients within a large collective has not been thoroughly analyzed yet. This study aimed at assessing the prevalence of pancreatic trauma in relation to the outcome and the currently established algorithm of treatment.
  
  
  METHODS
  Some 51,425 patients from the Trauma Register of the German Society of Trauma Surgery (TR DGU) (1993-2009) were retrospectively analyzed. All patients with an "injury severity score" ≥16, direct admission to a trauma center and subsequent treatment for at least 3 days, age ≥16, and an abdominal injury [abbreviated injury scale (AIS)(abdomen) ≥2] were included. Patients with abdominal trauma (AIS(abdomen) ≥2) were compared with patients with an additional pancreatic trauma (AIS(pancreas) 2-5).
  
  
  RESULTS
  Of 51,425 patients, 9,268 (18%) had documented abdominal injuries. Two hundred eighty-four (3.1%) patients with abdominal injury additionally showed a pancreatic injury (AIS(abdomen) ≥2, AIS(pancreas) 2-5) and were analyzed in dependency of the classification of the American Association for the Surgery of Trauma (AAST) organ severity score. AAST-pancreas: II°, 1.9%; III°, 0.6%; IV°, 0.3%; and V°, 0.2%. Patients with leading pancreatic injury (grades IV and V) thereby showed a significant increase of mortality (IV°, 30.0% and V°, 33.3%) and an increase of the need for surgical intervention (IV°, 80.6% and V°: 81.8%).
  
  
  CONCLUSIONS
  The results presented here show the prevalence and the outcome of pancreas injury in a large collective within the TR DGU for the first time. Based on the current literature and the findings, a treatment algorithm has been developed.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Hufelandstrasse 55, 45122 Essen, NRW, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Heuer
authors.forename: Björn
authors.initials: B
authors.lastname: Hussmann
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.forename: Georg
authors.initials: G
authors.lastname: Taeger
authors.forename: Gernot M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Sven
authors.initials: S
authors.lastname: Lendemans
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods; D010182:Pancreatic Diseases / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D015995:Prevalence; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents