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KMID : 1033220230130010021
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Journal of Acute Care Surgery
2023 Volume.13 No. 1 p.21 ~ p.26
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Management of Adult Blunt Renal Injury: A 10-Year Retrospective Review at a Single Institution
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Kim Jin-Soo
Kim Ki-Hoon
Kim Se-Hun
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Abstract
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Purpose: Renal injury occurs in up to 5% of trauma cases and the kidney is the third most woundedabdominal organ. The study objective was to analyze clinical characteristics of patients with blunt renaltrauma and review the treatment of high-grade blunt renal injuries.
Methods: The medical charts of trauma patients who visited Haeundae Paik Hospital between March2010 and February 2020 were retrospectively analyzed. Data on demographics, injury patterns, clinicalpresentation, management, and outcomes were analyzed.
Results: A total of 68 patients with renal trauma were included in this study. The most common renalinjury was Grade III (n = 27, 39.7%). Falling was the predominant mechanism of injury (n = 33, 48.5%),and 23.5% (n = 16) of patients sustained isolated renal trauma. Organ damage related to kidney injuryincluded chest injury (57.4%, n = 39) and abdominal or pelvic content injury (48.5%, n = 33). Theoverall mortality rate was 2.9% (n = 2). There were 45 cases of high-grade renal trauma (AAST Kidneyinjury scale Grade Ш-V). There was no statistical difference in the outcomes of high-grade (n = 44,97.8%) and low-grade (n = 23, 100%) renal trauma patients who received nonoperative treatment (p =0.511). Variables did not differ significantly, except for the injury severity score which was statisticallysignificantly different between low-grade and high-grade renal trauma patients (p = 0.001).
Conclusion: Most patients with traumatic renal injury, even those with high-grade injury, can bemanaged by nonoperative treatment, and have a good prognosis.
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KEYWORD
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blunt injury, kidney, review, trauma
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