Postoperative hemorrhage following pancreatic injury: Risk factors and clinical outcomes.

Background: Postoperative hemorrhage (POH) is a severe adverse event following pancreatic injury. The present study aimed to investigate the risk factors and outcomes of POH after pancreatic injury.
Methods: All patients with a confirmed diagnosis of pancreatic injury who underwent surgical intervention between January 2010 and December 2018 were identified and extracted from the trauma database. Logistic regression was performed to identify the risk factors for POH and specific outcomes.
Results: A total of 88 cases that underwent surgical intervention were analyzed, and POH occurred in 31 (35.23%) patients. After multivariable analysis, independent predictors of POH were intra-abdominal abscess (IAA) (p = .002), intestinal fistula (p = .008), shock on admission (p = .003), absence of abdominal suction drainage (p = .005), and higher body mass index (BMI) (p = .005). In addition, patients with POH after pancreatic injury also showed more complications, prolonged hospital and ICU durations, and a significantly higher mortality rate (p = .004).
Conclusions: Patients with IAA, intestinal fistula, shock on admission, absence of abdominal suction drainage, and higher BMI score were associated with POH after pancreatic injury. Moreover, POH was associated with a poor prognosis.
Clinical Trial Register: The study was registered on ClinicalTrials.gov (Unique identifier: NCT03681041).
(© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)