Predictive indications of operation and mortality following renal trauma

Abstract

In conclusion, ISS ≥ 16 and RIS ≥ 4 are predictive factors for necessitating an operation, and higher injury severity (ISS ≥ 16) and lower consciousness level (GCS < 8) scores are significantly associated with mortality after renal trauma.

Factors predicting the outcome of non-operative management of high-grade blunt renal trauma

“…17.1% of their patients required emergency intervention, with grade V injury and the need for platelet transfusion significantly predicting the need for intervention. More recently, in a retrospective review of 73 patients with renal injuries, Yang et al [18], reported that an injury severity score ≥16 and a renal injury score ≥4 were predictive of the necessity of surgery. Shariat et al [19] confirmed that the AAST injury severity scale is a powerful predictor of clinical outcome in renal trauma patients.…”

Predictive factors for operation and mortality following renal trauma

“…Therefore, the optimal management of major blunt and penetrating renal injuries remains controversial and deserves further evaluation. 5 In this issue, Dr. Yang and colleagues 6 have done a good job of finding the factors predictive of surgery and mortality in patients with renal injury.…”

“…5 In their article, Yang and others 6 conclude that Injury Severity Score (ISS) 16 and Renal Injury Scale (RIS) 4 are predictive factors for operation, and that higher injury severity (ISS 16) and lower conscious level (Glasgow Coma Scale (GCS) < 8) are significantly associated with mortality after renal trauma. 6 However, the authors could give more details about this scale and describe the numbers of patients in different RIS scales and their prognoses, because they want to find the predictive factors for surgery and mortality after renal trauma. In this way, the readers could get more information from the article.…”

“…If there is only a partial tear, then nephrostomy or ureteral stenting (double-J) can be suggested, but complete transection or severe tear of ureteropelvic junction requires immediate or delayed surgery. 5 Maybe Yang and coworkers 6 could have some discussion about the use of angiography and nephrostomy in such patients.…”

“…14 In addition, Lee and others 15 reported that severely injured kidney could be preserved by Vicryl mesh instead of nephrectomy in an animal study. Maybe Yang and colleagues 6 could describe more about the types of surgery in patients with renal trauma such as partial nephrectomy in the discussion, which might make the paper more informative and raise the interest of readers.…”