PURPOSE: The bladder is the most commonly injured genitourinary organ from blunt pelvic trauma. In this study we describe traumatic bladder injuries in the United States, their management and association with mortality. MATERIALS AND METHODS: We queried the 2002 to 2006 National Trauma Data Bank for all subjects with bladder injury. Demographics, mechanism of injury, coexisting injuries, type of bladder injury, and operative interventions for bladder and other abdominal trauma are described. Multivariate logistic regression analysis was used to examine the relationship between bladder injury and in-hospital mortality. RESULTS: Of 8,565 subjects with bladder trauma 46% had pelvic fracture and 15% had 2 or more intra-abdominal injuries. Of these subjects 54% underwent bladder surgery, including 76% with intraperitoneal injury and 51% with surgical repair of other abdominal organs. On multivariate analysis operative bladder repair reduced the likelihood of in-hospital mortality by 59%. Greater likelihood of death was seen in African-American and Native American patients, and those with pelvic injuries, triage to higher acuity care, penetrating trauma and multiple abdominal injuries. CONCLUSIONS: We demonstrated that surgical repair provides a significant survival advantage for subjects with bladder trauma. With 76% of intraperitoneal bladder injuries being repaired, there appears to be underuse of a lifesaving procedure. Additional studies to refine indications for bladder repair are warranted.
PURPOSE: The bladder is the most commonly injured genitourinary organ from blunt pelvic trauma. In this study we describe traumatic bladder injuries in the United States, their management and association with mortality. MATERIALS AND METHODS: We queried the 2002 to 2006 National Trauma Data Bank for all subjects with bladder injury. Demographics, mechanism of injury, coexisting injuries, type of bladder injury, and operative interventions for bladder and other abdominal trauma are described. Multivariate logistic regression analysis was used to examine the relationship between bladder injury and in-hospital mortality. RESULTS: Of 8,565 subjects with bladder trauma 46% had pelvic fracture and 15% had 2 or more intra-abdominal injuries. Of these subjects 54% underwent bladder surgery, including 76% with intraperitoneal injury and 51% with surgical repair of other abdominal organs. On multivariate analysis operative bladder repair reduced the likelihood of in-hospital mortality by 59%. Greater likelihood of death was seen in African-American and Native American patients, and those with pelvic injuries, triage to higher acuity care, penetrating trauma and multiple abdominal injuries. CONCLUSIONS: We demonstrated that surgical repair provides a significant survival advantage for subjects with bladder trauma. With 76% of intraperitoneal bladder injuries being repaired, there appears to be underuse of a lifesaving procedure. Additional studies to refine indications for bladder repair are warranted.
Authors: B Phillips; S Holzmer; L Turco; M Mirzaie; E Mause; A Mause; A Person; S W Leslie; D L Cornell; M Wagner; R Bertellotti; J A Asensio Journal: Eur J Trauma Emerg Surg Date: 2017-07-20 Impact factor: 3.693
Authors: Herman S Bagga; Gregory E Tasian; Patrick B Fisher; Charles E McCulloch; Jack W McAninch; Benjamin N Breyer Journal: J Urol Date: 2012-11-02 Impact factor: 7.450
Authors: Ross E Anderson; Sorena Keihani; Rachel A Moses; Alexander P Nocera; J Patrick Selph; Clara M Castillejo Becerra; Nima Baradaran; Katie Glavin; Joshua A Broghammer; Chirag S Arya; Rachel L Sensenig; Michael E Rezaee; Bradley J Morris; Sarah Majercik; Timothy Hewitt; Frank N Burks; Ian Schwartz; Sean P Elliott; Xian Luo-Owen; Kaushik Mukherjee; Peter B Thomsen; Bradley A Erickson; Brandi D Miller; Richard A Santucci; LaDonna Allen; Scott Norwood; Cameron N Fick; Brian P Smith; Joshua Piotrowski; Christopher M Dodgion; Erik S DeSoucy; Scott Zakaluzny; Dennis Y Kim; Benjamin N Breyer; Barbara U Okafor; Reza Askari; Jacob W Lucas; Jay Simhan; Seyyed Saeed Khabiri; Raminder Nirula; Jeremy B Myers Journal: J Urol Date: 2020-04-07 Impact factor: 7.450