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Management of Major Blunt Renal Injury: A Twelve-Year Review at an Urban, Level I Trauma Hospital.

Abstract The aim of this study was to describe the management of severe blunt renal injuries at a Level I trauma hospital. Data were collected through a record review of patients admitted from January 1, 2000, to December 31, 2011. These data were compiled as part of our hospital's participation in the Nonoperative Management of Grade IV and V Blunt Renal Injuries: A Research Consortium of New England Centers for Trauma Study. Thirty-six patients with severe blunt renal injuries were identified. Twenty-nine (80.6%) underwent nonoperative management (NOM) for their injuries. Seven (19.4%) received an immediate operation because of hemodynamic instability or CT findings of large hemoperitoneum or extravasation. No significant differences were observed on Injury Severity Score, Glasgow Coma Scale, injury grade, or systolic blood pressure on arrival to the emergency department. On arrival, the operative patients had higher heart rates and lower hematocrit and hemoglobin values relative to the NOM patients. The kidney was salvaged in three of the seven operative patients and was either saved or partially saved in all except one NOM patient. Three NOM patients died; none because of renal injuries. All other patients were successfully managed. None of the operative patients died. NOM management of high-grade renal injury was successful for these patients and should be considered in the management of grade IV and V blunt renal trauma.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 29559064
OWN - NLM
STAT- MEDLINE
DCOM- 20180327
LR  - 20180327
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 84
IP  - 3
DP  - 2018 Mar 1
TI  - Management of Major Blunt Renal Injury: A Twelve-Year Review at an Urban, Level I
      Trauma Hospital.
PG  - 451-454
AB  - The aim of this study was to describe the management of severe blunt renal
      injuries at a Level I trauma hospital. Data were collected through a record
      review of patients admitted from January 1, 2000, to December 31, 2011. These
      data were compiled as part of our hospital's participation in the Nonoperative
      Management of Grade IV and V Blunt Renal Injuries: A Research Consortium of New
      England Centers for Trauma Study. Thirty-six patients with severe blunt renal
      injuries were identified. Twenty-nine (80.6%) underwent nonoperative management
      (NOM) for their injuries. Seven (19.4%) received an immediate operation because
      of hemodynamic instability or CT findings of large hemoperitoneum or
      extravasation. No significant differences were observed on Injury Severity Score,
      Glasgow Coma Scale, injury grade, or systolic blood pressure on arrival to the
      emergency department. On arrival, the operative patients had higher heart rates
      and lower hematocrit and hemoglobin values relative to the NOM patients. The
      kidney was salvaged in three of the seven operative patients and was either saved
      or partially saved in all except one NOM patient. Three NOM patients died; none
      because of renal injuries. All other patients were successfully managed. None of 
      the operative patients died. NOM management of high-grade renal injury was
      successful for these patients and should be considered in the management of grade
      IV and V blunt renal trauma.
FAU - Joseph, D'Andrea K
AU  - Joseph DK
FAU - Daman, Daniel
AU  - Daman D
FAU - Kinler, Rae Lynne
AU  - Kinler RL
FAU - Burns, Karyl
AU  - Burns K
FAU - Jacobs, Lenworth
AU  - Jacobs L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Adult
MH  - Blood Pressure/physiology
MH  - Female
MH  - Glasgow Coma Scale
MH  - Heart Rate/physiology
MH  - Hematocrit
MH  - Hemoglobins/analysis
MH  - Hospitals, Urban/statistics & numerical data
MH  - Humans
MH  - Injury Severity Score
MH  - Kidney/*injuries
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Trauma Centers/statistics & numerical data
MH  - Wounds, Nonpenetrating/mortality/physiopathology/*therapy
EDAT- 2018/03/22 06:00
MHDA- 2018/03/28 06:00
CRDT- 2018/03/22 06:00
PHST- 2018/03/22 06:00 [entrez]
PHST- 2018/03/22 06:00 [pubmed]
PHST- 2018/03/28 06:00 [medline]
PST - ppublish
SO  - Am Surg. 2018 Mar 1;84(3):451-454.