MRI timing and clinical outcomes in blunt moderate-severe pancreatic trauma: Implications for practice management and...

This analysis will evaluate the impact of magnetic resonance imaging (MRI) timing (≤24 h versus >24 h) from emergency department (ED) arrival on injury characteristics and clinical outcomes in adult trauma patients with blunt moderate-severe abdominal pancreatic injury.

A retrospective cohort analysis was performed using the American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) database. Adult patients with moderate-severe (ISS ≥ 9) blunt abdominal trauma (AIS abdomen >2) who underwent abdominal MRI were included. Outcomes included mortality, time to surgical intervention, intensive care unit length of stay (ICU-LOS), ventilator-free days (VFDs), complication rates, and discharge disposition.

Receiving MRI ≤24 h from ED arrival was associated with lower mortality (aOR 0.335, p = 0.332), significantly less time to intervention (β -26.190, p = 0.027), and significantly shorter ICU-LOS (β = -2.948, p = 0.031) compared to patients receiving MRI > 24 h. There were no significant differences in VFDs (β 0.979, p = 0.692) or in-hospital complications (aOR 0.088, p = 0.124-0.999) between groups. Patients receiving MRI ≤24 h were significantly more likely to be discharged home (aOR 2.839, p = 0.044) and significantly less likely to be discharged to an acute rehabilitation facility (aOR 0.104, p = 0.004) compared to MRI > 24 h.

MRI utilization within 24 h of ED arrival has resulted in detecting the majority of pancreatic traumatic injuries with various severity & anatomic regions, reduced mortality odds, significantly reduced ICU-LOS days, shorter time to surgical intervention, and increased likelihood of home discharge, with no significant differences in complication rates compared to those receiving MRI > 24 h.