BACKGROUND: To evaluate the extent to which nonoperative renal trauma management has been adopted, we determined the incidence of renal injury and the rate of operative management across the United States. METHODS: International Classification of Diseases, Ninth Revision diagnosis and procedure codes identified patients with renal injuries in an 18-state administrative database representing 62% of the U.S. population. RESULTS: Of 523,870 patients hospitalized for trauma in 1997 or 1998, 6,231 (1.2%) had renal injuries (4.89 per 100,000 population). Sixty-four percent of patients with injuries that were classified had contusions/hematomas, 26.3% had lacerations, 5.3% had parenchymal disruption, and 4% had vascular injuries. Eleven percent of renal trauma patients required surgical management of their kidney injuries, of whom 61%, or 7% of patients with renal injuries overall, underwent nephrectomy. Injury Severity Score, mechanism, and renal injury severity were independent predictors of nephrectomy. CONCLUSION: The nephrectomy rate in community and academic centers reflects renal and global injury severity. Prospective trials are indicated to determine whether, in the traumatized patient with severe kidney injury, renal preservation could lead to improved outcomes compared with nephrectomy.
BACKGROUND: To evaluate the extent to which nonoperative renal trauma management has been adopted, we determined the incidence of renal injury and the rate of operative management across the United States. METHODS: International Classification of Diseases, Ninth Revision diagnosis and procedure codes identified patients with renal injuries in an 18-state administrative database representing 62% of the U.S. population. RESULTS: Of 523,870 patients hospitalized for trauma in 1997 or 1998, 6,231 (1.2%) had renal injuries (4.89 per 100,000 population). Sixty-four percent of patients with injuries that were classified had contusions/hematomas, 26.3% had lacerations, 5.3% had parenchymal disruption, and 4% had vascular injuries. Eleven percent of renal traumapatients required surgical management of their kidney injuries, of whom 61%, or 7% of patients with renal injuries overall, underwent nephrectomy. Injury Severity Score, mechanism, and renal injury severity were independent predictors of nephrectomy. CONCLUSION: The nephrectomy rate in community and academic centers reflects renal and global injury severity. Prospective trials are indicated to determine whether, in the traumatized patient with severe kidney injury, renal preservation could lead to improved outcomes compared with nephrectomy.
Authors: M Kontos; E Felekouras; E Drakos; E Pikoulis; D Mitropoulos; C Staikou; D Hatzianastasiou; F Sigala; A Papalois; E Papalambros; E Bastounis Journal: Surg Endosc Date: 2004-11-11 Impact factor: 4.584
Authors: Allen F Morey; Steve Brandes; Daniel David Dugi; John H Armstrong; Benjamin N Breyer; Joshua A Broghammer; Bradley A Erickson; Jeff Holzbeierlein; Steven J Hudak; Jeffrey H Pruitt; James T Reston; Richard A Santucci; Thomas G Smith; Hunter Wessells Journal: J Urol Date: 2014-05-20 Impact factor: 7.450
Authors: P Chiron; E Hornez; G Boddaert; M Dusaud; Y Bayoud; B Molimard; F R Desfemmes; X Durand Journal: Eur J Trauma Emerg Surg Date: 2015-05-19 Impact factor: 3.693
Authors: Marc A Bjurlin; Richard Jacob Fantus; Richard Joseph Fantus; Michele M Mellett; Dana Villines Journal: J Urol Date: 2014-05-17 Impact factor: 7.450
Authors: Darshan P Patel; Jeffrey D Redshaw; Benjamin N Breyer; Thomas G Smith; Bradley A Erickson; Sarah D Majercik; Thomas W Gaither; James R Craig; Scott Gardner; Angela P Presson; Chong Zhang; James M Hotaling; William O Brant; Jeremy B Myers Journal: Injury Date: 2015-03-01 Impact factor: 2.586
Authors: David B Bayne; Anas Tresh; Nima Baradaran; Gregory Murphy; E Charles Osterberg; Shellee Ogawa; Jessica Wenzel; Lindsay Hampson; Jack McAninch; Benjamin Breyer Journal: World J Urol Date: 2018-10-01 Impact factor: 4.226