Adrenal hemorrhage: a comparison of traumatic and nontraumatic deaths.

The purpose of this study was both to define the incidence of adrenal injury/hemorrhage in fatal motor vehicle accidents and myocardial infarctions and determine if adrenal hemorrhage is a terminal event or is caused by the traumatic event. Two hundred sixty-nine deaths were caused by motor vehicle accidents or blunt force, with 21 (7.8%) patients experiencing adrenal hemorrhage. Two hundred sixty-two deaths resulted from myocardial infarction with none of these patients experiencing adrenal hemorrhage. The 7% incidence of adrenal hemorrhage or injury is in the range previously reported in the literature. The statistically significant difference in the incidence of adrenal hemorrhage in this study suggests that the hemorrhage is the result of injury rather than a terminal event. Thus, we have concluded that some patients with severe blunt abdominal trauma may benefit from exogenous steroid administration, since the adrenal hemorrhage is caused by the traumatic event.