Features and outcomes of patients with grade IV renal injury

BJU International
Shahrokh F ShariatPierre I Karakiewicz

Abstract

To evaluate the clinical features and outcomes of patients who presented with grade IV renal trauma to our urban level I trauma hospital and to further refine the absolute indications for exploration and determine the outcomes of conservative management. In all, 77 patients with grade IV traumatic renal injuries presented to our emergency department between October 1997 and October 2006. A prospective trauma database including these patients was analysed to determine the patterns of injury, operative outcomes and complications. A quarter of the patients had gunshot injuries, 9% had stab injuries, and 66% had blunt traumas. In all, 36% of patients required surgical exploration to treat associated non-urological injuries. There was no or microscopic haematuria in 29% of the patients. Of the 32 patients who underwent renal exploration, 63% (20/32) underwent renorrhaphy and 37% (12/32) underwent nephrectomy. In multivariate analyses, only gunshot injury, surgery for non-urological injury, and volume of blood transfused were significantly associated with the need for renal exploration (P = 0.015, P = 0.041, and P = 0.032, respectively). The renal complication rate was higher in patients managed conservatively vs those who underwent ...Continue Reading

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Citations

Jul 24, 2013·Nature Reviews. Urology·Molly Williams, James Jezior
Jun 14, 2013·Case Reports in Urology·Parth K ShahRowena A Desouza
Jan 21, 2015·BJU International·Darren J Bryk, Lee C Zhao
Dec 20, 2011·The Journal of Urology·James M HotalingBryan B Voelzke
Nov 16, 2010·The Journal of Urology·James McGuireNiall M Corcoran
Mar 24, 2016·Der Urologe. Ausg. A·A Hegele
Jun 17, 2016·Der Urologe. Ausg. A·U Krafft
Feb 22, 2017·Journal of the Chinese Medical Association : JCMA·Zhi-Qiang CaoYaling Han
Feb 14, 2018·BJU International·Marios HadjipavlouDavendra Sharma
Aug 20, 2019·The Journal of Trauma and Acute Care Surgery·Morgan SchellenbergDemetrios Demetriades
Sep 8, 2011·Current Opinion in Urology·Ofer Z Shenfeld, Ehud Gnessin
Jan 29, 2013·The Journal of Trauma and Acute Care Surgery·Miranda Jo HardeeJeremy B Myers
Dec 23, 2016·Emergency Radiology·Arthur H BaghdanianStephan W Anderson

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