JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Severe blunt renal trauma: a 7-year retrospective review from a provincial trauma centre.

BACKGROUND: Renal trauma is reported in 3% of trauma patients. The majority (>90%) are due to blunt mechanisms of injury. Minor renal injuries pose few management difficulties and the majority are managed expectantly. More serious injuries are potentially life threatening and have been historically managed by operative intervention with repair of the injured kidney when possible. More recently, there has been a trend towards non-operative management of all solid intra-abdominal organ injury including renal trauma. The purpose of this study was to review a 7-year experience in renal trauma at a provincial trauma centre and to define management practices along with patient and organ outcomes in severe renal injury.

METHODS: The BC Trauma Registry was reviewed for all admissions from January 1, 1992 to December 31, 1998 to identify patients with renal injury. Patient charts were reviewed to determine sex, age, mechanism of injury, vitals, imaging, associated injuries, and management and outcomes. Renal injuries were graded according to the American Association for the Surgery of Trauma Grading System.

RESULTS: During the study period 16 250 consecutive trauma cases were seen at Vancouver General Hospital. Of these cases, 227 (1.4%) patients sustained renal injuries: blunt in 93.4% and penetrating in 6.6%. Among patients with blunt renal trauma, 18.3% were grade III, IV, or V injuries. In this population, nearly 80% had associated trauma and also 80% had gross hematuria. Management was conservative in 87.5% of grade III and 77.7% of grade IV; however, 90.9% of grade V injuries went immediately to the OR. Nephrectomy rates were: 12.5% (III), 16.6% (IV), and 90.9% (V) with an overall exploration rate of 7.1% for all blunt renal trauma. Blunt renal trauma patients experienced few genitourinary complications. Overall, 3 patients of 40 with grade III, IV or V injuries died due to cardiac arrest in the emergency room.

CONCLUSIONS: Blunt renal trauma managed conservatively is associated with few complications in the hemodynamically stable patient. Grade V injuries still result in a nephrectomy rate of 90.9% with hemodynamic instability the indication in 100% of patients.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app