Gwen M Grimsby1, Bryan Voelzke2, James Hotaling3, Mathew D Sorensen4, Martin Koyle5, Micah A Jacobs6. 1. Division of Pediatric Urology, Department of Urology, UT Southwestern Medical Center, Dallas, Texas. 2. Department of Urology, University of Washington School of Medicine, Seattle, Washington. 3. Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, Utah. 4. Department of Urology, University of Washington School of Medicine, Seattle, Washington; Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington. 5. University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada. 6. Division of Pediatric Urology, Department of Urology, UT Southwestern Medical Center, Dallas, Texas. Electronic address: Micah.Jacobs@Childrens.com.
Abstract
PURPOSE: There is a lack of national data describing the demographics and nature of pediatric renal trauma. We used the National Trauma Data Bank to analyze mechanisms and grades of injury, demographics and treatment characteristics of pediatric renal trauma cases. MATERIALS AND METHODS: Renal injuries were identified by Abbreviated Injury Scale codes and converted to American Association for the Surgery of Trauma renal injury grades. Patients were stratified by age (0 to 1, 2 to 4, 5 to 14 and 15 to 18 years) for more specific analyses of mechanisms and grades of injury. Data reviewed included mechanisms and grades of renal injury, demographics, and setting and type of treatment. RESULTS: A total of 2,213 pediatric renal injuries were converted to American Association for the Surgery of Trauma grade. Mean ± SD age at injury was 13.7 ± 4.4 years, with 2,089 patients (94%) being 5 to 18 years old. Of the injuries 79% were grade I, II or III. Penetrating injury accounted for less than 10% of all pediatric renal injuries. A majority of patients (57%) were admitted to university hospitals with a dedicated trauma service (73%) and only 12% of patients were admitted to a pediatric hospital. A total of 122 nephrectomies (5.5%) were performed. CONCLUSIONS: Most renal trauma in children is low grade, is blunt in nature and occurs after age 5 years. The majority of these cases are managed at adult hospitals. Although most patients are treated conservatively, the rate of nephrectomy is 3 times higher at adult hospitals than at pediatric centers.
PURPOSE: There is a lack of national data describing the demographics and nature of pediatric renal trauma. We used the National Trauma Data Bank to analyze mechanisms and grades of injury, demographics and treatment characteristics of pediatric renal trauma cases. MATERIALS AND METHODS:Renal injuries were identified by Abbreviated Injury Scale codes and converted to American Association for the Surgery of Trauma renal injury grades. Patients were stratified by age (0 to 1, 2 to 4, 5 to 14 and 15 to 18 years) for more specific analyses of mechanisms and grades of injury. Data reviewed included mechanisms and grades of renal injury, demographics, and setting and type of treatment. RESULTS: A total of 2,213 pediatric renal injuries were converted to American Association for the Surgery of Trauma grade. Mean ± SD age at injury was 13.7 ± 4.4 years, with 2,089 patients (94%) being 5 to 18 years old. Of the injuries 79% were grade I, II or III. Penetrating injury accounted for less than 10% of all pediatric renal injuries. A majority of patients (57%) were admitted to university hospitals with a dedicated trauma service (73%) and only 12% of patients were admitted to a pediatric hospital. A total of 122 nephrectomies (5.5%) were performed. CONCLUSIONS: Most renal trauma in children is low grade, is blunt in nature and occurs after age 5 years. The majority of these cases are managed at adult hospitals. Although most patients are treated conservatively, the rate of nephrectomy is 3 times higher at adult hospitals than at pediatric centers.
Authors: Gregory P Murphy; Thomas W Gaither; Mohannad A Awad; E Charles Osterberg; Nima Baradaran; Hillary L Copp; Benjamin N Breyer Journal: Curr Urol Rep Date: 2017-03 Impact factor: 3.092
Authors: Federico Coccolini; Ernest E Moore; Yoram Kluger; Walter Biffl; Ari Leppaniemi; Yosuke Matsumura; Fernando Kim; Andrew B Peitzman; Gustavo P Fraga; Massimo Sartelli; Luca Ansaloni; Goran Augustin; Andrew Kirkpatrick; Fikri Abu-Zidan; Imitiaz Wani; Dieter Weber; Emmanouil Pikoulis; Martha Larrea; Catherine Arvieux; Vassil Manchev; Viktor Reva; Raul Coimbra; Vladimir Khokha; Alain Chichom Mefire; Carlos Ordonez; Massimo Chiarugi; Fernando Machado; Boris Sakakushev; Junichi Matsumoto; Ron Maier; Isidoro di Carlo; Fausto Catena Journal: World J Emerg Surg Date: 2019-12-02 Impact factor: 5.469