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• W4386945952 abstract "Renal trauma constitutes 0.5% − 5% of all trauma patients, and 10% − 20% of abdominal trauma. It is the most commonly injured organ in the genitourinary tract. Road traffic crash is the most common cause. In recent years due to the advances in radiological imaging and endovascular techniques, there has been an increase in the nonoperative management of renal trauma. We investigated a large trauma cohort at a level I trauma centre to evaluate patients' demographics with renal trauma, their management, and the outcomes. This was a retrospective analysis of the prospectively collected data of renal trauma patients managed from January 2016 to December 2020. Patients visited the level I trauma centre in north India with a renal trauma were included in this study. Patients with non-renal trauma or patients who were dead on arrival in the emergency department were excluded. Demographics, mechanism of injury, presence of hemorrhagic shock, associated injuries, complications, length of hospital stay, discharge, and mortality were recorded. The data were entered in Microsoft Excel 365 and analysed using SPSS version 21. This study collected data of 303 renal trauma patients. Males constituted 86.5% of the patients. Most patients were young, aged from the 20 to 40 years. Blunt renal trauma was the predominant mode of injury (n = 270, 89.1%). Road traffic crashes (n = 190, 62.7%) and falls from height (n = 65, 21.4%) were the two most common mechanisms of injury. Focused assessment with sonography in trauma was positive in 68.4% of patients. Grade III (grading by American Association for the Surgery of Trauma) renal trauma (30.4%) was the most common grade in our study. The liver (n = 104, 34.3%) and splenic trauma (n = 96, 31.7%) were the most commonly associated injuries. Of the 303 patients, 260 (85.8%) were managed nonoperatively. The mean (SD) of the patients’ length of hospital stay was 12.5 (6.5) days. There were 25 (8.3%) mortalities during the study period and all of them had associated other injuries. The comparison of length of hospital stay of isolated renal trauma group and renal trauma with associated injuries group was not statistically significant (p = 0.322). All the patients who died during the study period had renal trauma with associated other organ injuries. None of the patients with isolated renal trauma died during the study. The outcome comparison between both groups was not statistically significant (p = 0.110). Renal trauma predominantly involves in young males, especially due to road traffic crashes followed by fall from height. Focused assessment with sonography in trauma is not reliable in detecting renal injuries, other diagnostic tools such as contrast enhanced computed tomography torso should be considered in diagnosing and grading these injuries. Renal trauma usually does not occur in isolation. Majority are associated with other abdominal and extra abdominal injuries. Most of the times these injuries can be managed nonoperatively, which can achieve a low mortality. The patients who required surgery had high mortality as compared to patients managed nonoperatively. These patients who required surgery had either severe renal or extra renal trauma and were in hemorrhagic. Renal trauma from this large cohort may contribute towards improving the quality of care for patients with renal trauma by obtaining knowledge about the patient's characteristics, management, and outcomes." @default.
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• W4386945952 date "2023-09-01" @default.
• W4386945952 modified "2023-09-28" @default.
• W4386945952 title "Analysis and approach to renal trauma: A five-year experience at a level I trauma centre in north India" @default.
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• W4386945952 doi "https://doi.org/10.1016/j.cjtee.2023.08.004" @default.
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