Revision of Current American Association for the Surgery of Trauma Renal Injury Grading System

Buckley, Jill C.; McAninch, Jack W.

doi:10.1097/ta.0b013e318207ad5a

Cited by 103 publications

(71 citation statements)

References 3 publications

(2 reference statements)

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“…Contrarily, the AUA recommends observation for hemodynamically stable patients regardless of AAST grade, due to interobserver variability regarding classification of grade 4 and 5 injuries (Grade B, AUA). With the increasing evidence of excellent outcomes of conservative management for correctly classified grade 4 injuries [16,17], there have been proposals to re-classify grade 4 and 5 injuries [18,19]; this would clarify the ambiguities of defining these injuries and may allow for more successful management decisions.…”

Section: Introductionmentioning

confidence: 99%

Guideline of guidelines: a review of urological trauma guidelines

2015

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ObjectiveTo review the guidelines released in the last decade by several organisations for the optimal evaluation and management of genitourinary injuries (renal, ureteric, bladder, urethral and genital). MethodsThis is a review of the genitourinary trauma guidelines from the European Association of Urology (EAU) and the American Urological Association (AUA), and renal trauma guidelines from the Soci et e Internationale d'Urologie (SIU). ResultsMost recommendations are guided by the American Association for the Surgery of Trauma (AAST) organ injury severity system. Grade A evidence is rare in genitourinary trauma, and most recommendations are based on Grade B or C evidence. The findings of the most recent urological trauma guidelines are summarised. All guidelines recommend conservative management for low-grade injuries. The major difference is for haemodynamically stable patients who have high-grade renal trauma; the SIU guidelines recommend exploratory laparotomy, the EAU guidelines recommend renal exploration only if the injury is vascular, and the AUA guidelines recommend initial conservative management. ConclusionThere is generally consensus among the three guidelines. Recommendations are based on observational or retrospective studies, as well as clinical principles and expert opinions. Multi-institutional collaborative research can improve the quality of evidence and direct more effective evaluation and management of urological trauma.

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Section: Introductionmentioning

confidence: 99%

Guideline of guidelines: a review of urological trauma guidelines

2015

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“…This classification enables a standardization of various renal trauma and a choice of a proper therapy and a prediction [16]. Medical management depends on the grades of renal trauma.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis value of multi-slice spiral CT in renal trauma

Peng

Wang

Zhang

et al. 2016

XST

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Abstract. Computed tomography (CT) is most commonly used as a noninvasive approach in diagnosis of internal organ injures. Use of multi-slice spiral CT becomes more popular in diagnosis of trauma because of its ability to generate 3D volumetric information. This study evaluated the diagnostic value of multi-slice spiral computed tomography (MSCT) with enhanced scanning in renal trauma. In total, 126 patients with kidney injury underwent MSCT scanning from a single hospital in the southern of China between January 2012 and February 2016. According to kidney injury grading standards of American Association for the Surgery of Trauma (AAST), 30 were diagnosed and classified in level I, 26 in level II, 42 in level III, 17 in level IV, 11 in level V. The outcomes of MSCT enhanced scanning achieve a 100% diagnostic accuracy rate, which was confirmed by surgical findings. We concluded that the enhanced MSCT scan permits reliable detection of renal trauma and the associated organ or tissue injuries, providing important clinical value for the diagnosis and classification of renal trauma or internal organ injures.

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“…Blunt trauma accounts for 80-90 % of GU injuries [ 6 , 7 ]; however, in an urban setting, penetrating trauma may cause up to 20 % of GU trauma [ 8 ]. In contrast, over three-fourths of the cases requiring surgical exploration are caused by penetrating injury [ 7 ]. In blunt trauma, 43 % of GU injuries are to the kidney, 9 % to the bladder, and 47 % to the external genitalia.…”

Section: Introductionmentioning

confidence: 99%

Trauma of the Kidney, Ureter, and Bladder

Shackelford¹

2015

The Shock Trauma Manual of Operative Techniques

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Revision of Current American Association for the Surgery of Trauma Renal Injury Grading System

Cited by 103 publications

References 3 publications

Guideline of guidelines: a review of urological trauma guidelines

Guideline of guidelines: a review of urological trauma guidelines

Diagnosis value of multi-slice spiral CT in renal trauma

Trauma of the Kidney, Ureter, and Bladder

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