Nationwide Procedural Trends for Renal Trauma Management

Colaco, Marc; Navarrete, Roberto; MacDonald, Susan; Stitzel, Joel D.; Terlecki, Ryan

doi:10.1097/sla.0000000000002475

Cited by 30 publications

(28 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may be partially due to changes in road safety regulations and behavioral patterns [21,22]. Regarding the management of blunt renal trauma, we observed an increase in the use of emergency abdominal angiography and a decline in nephrectomy, which is a similar trend to Western countries [6,7,23]. The mortality rate decreased from 15.3 to 7.3% over 15 years, which is a similar trend to previous studies [24].…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Nakao

Katayama

Hirayama³

et al. 2020

World J Emerg Surg

View full text Add to dashboard Cite

Background: There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods: We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results: We identified 3550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8%, and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: age ≥ 65 years (adjusted OR 3.36); pedestrian accident (adjusted OR 1.94); fall from height (adjusted OR 1.91); shock on arrival (adjusted OR 4.02); concomitant injuries to the head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90); AAST grades III-V (adjusted ORs 1.42, 2.16, and 5.55); and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: shock on arrival (adjusted OR 1.98), concomitant injuries to the thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grades III, IV, and V (adjusted ORs 18.40, 113.89, and 468.17), and emergency abdominal angiography (adjusted OR 0.28). Conclusions: We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population.

show abstract

Section: Discussionsupporting

confidence: 83%

“…5 Kyoto University Health Service, Kyoto, Japan. 6 Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. 7 Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan.…”

Section: Acknowledgementsmentioning

confidence: 99%

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Nakao

Katayama

Hirayama³

et al. 2020

World J Emerg Surg

View full text Add to dashboard Cite

show abstract

“…21,22 Regarding the management of blunt renal trauma, we observed an increase in the use of emergency abdominal angiography and a decline in nephrectomy, which is a similar trend to Western countries. 6,7,23 The mortality rate decreased from 15.3 % to 7.3% over 15 years, which is a similar trend to previous studies. 24…”

Section: Discussionsupporting

confidence: 89%

“…4,5 In recent years, less invasive interventions, such as endovascular procedures, have increasingly been used for blunt renal trauma. 6,7 Nevertheless, nephrectomy is still required for unstable patients those in whom non-operative management fails. 8,9,10 According to a report by van der Wilden et al, among patients injured by road tra c accidents, non-operative management failed in 27.3% of the patients who were > 55 years of age.…”

Section: Introductionmentioning

confidence: 99%

Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

Nakao

Katayama

Hirayama

et al. 2020

Preprint

View full text Add to dashboard Cite

Background There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management, and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results We identified 3,550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8% and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography, and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: age ≥ 65 years (adjusted OR 3.36), pedestrian accident (adjusted OR 1.94), fall from height (adjusted OR 1.91), shock on arrival (adjusted OR 4.02), concomitant injuries to head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90), AAST grade III-V (adjusted ORs 1.42, 2.16 and 5.55), and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: shock on arrival (adjusted OR 1.98), concomitant injuries to thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grade III, IV and V (adjusted ORs 18.40, 113.89, and 468.17) and emergency abdominal angiography (adjusted OR 0.28). Conclusions We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population. Trial registration: Not applicable

show abstract

“…Adjusted replaced the past tendency toward aggressive surgical exploration in select, well-staged, and hemodynamically stable cases [8,27,28]. The time trend of renal trauma management has recently been studied, but has not previously been evaluated at the level of tiered trauma systems or interfacility transfer [29]. We found that overall odds of morality were lower in those with level I transfers, compared with those managed at a non-level I trauma center.…”

Section: Crudementioning

confidence: 80%

Impact of Trauma Center Designation and Interfacility Transfer on Renal Trauma Outcomes: Evidence for Universal Management

Bjurlin

Renson

Fantus

et al. 2019

European Urology Focus

View full text Add to dashboard Cite

Nationwide Procedural Trends for Renal Trauma Management

Cited by 30 publications

References 12 publications

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

Impact of Trauma Center Designation and Interfacility Transfer on Renal Trauma Outcomes: Evidence for Universal Management

Contact Info

Product

Resources

About