Author:
Deininger Christian,Freude Thomas,Wichlas Florian,Kriechbaumer Lukas Konstantin,Deininger Sebastian Hubertus Markus,Törzsök Peter,Lusuardi Lukas,Pallauf Maximilian,Deluca Amelie,Deininger Susanne
Abstract
Abstract
Purpose
The aim of this study was to analyze the injury patterns and clinical course of a winter sport dominated by blunt renal trauma collective.
Methods
Blunt renal trauma cases (N = 106) treated in a Level 1 Trauma Center in Austria were analyzed.
Results
We encountered 12.3% grade 1, 10.4% grade 2, 32.1% grade 3, 38.7% grade 4 and 6.6% grade 5 renal traumata classified according to the American Association for the Surgery of Trauma (AAST). The mechanisms of injury (MOI) did not have an influence on the frequency of HG trauma (i.e., grade 4 and 5). No concomitant injuries (CIs) were found in 57.9% of patients. The number of patients without CIs was significantly higher in the sports associated trauma group compared to other MOIs (p < 0.01). In 94.3% the primary treatment was a non-operative management (NOM) including 56.6% conservative, 34.0% endourological, and 3.8% interventional therapies. A follow-up computed tomography (FU-CT) was performed in 81.1%, 3.3 days after trauma. After FU-CT, the primary therapy was changed in 11.4% of cases (grade ≥ 3). Comparing the Hb loss between the patients with grade 3 and 4 kidney trauma with and without revision surgery, we find a significantly increased Hb loss within the first 96 h after the trauma in the group with a needed change of therapy (p < 0.0001). The overall rate of nephrectomy (primary or secondary) was 9.4%. Independent predictors of nephrectomy were HG trauma (p < 0.01), age (p < 0.05), and sex (p < 0.05). The probability of nephrectomy was lower with (winter) sports-associated trauma (p < 0.1).
Conclusions
Sports-associated blunt renal trauma is more likely to occur isolated, and has a lower risk of severe outcomes, compared to other trauma mechanisms. NOM can successfully be performed in over 90% of all trauma grades.
Funder
Paracelsus Medical University
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine,Orthopedics and Sports Medicine,Emergency Medicine,Surgery
Reference23 articles.
1. Lendemans S, Heuer M, Nast-Kolb D, Kuhne CA, Dammann M, Lefering R, Flohe S, Ruchholtz S, Taeger G. Significance of liver trauma for the incidence of sepsis, multiple organ failure and lethality of severely injured patients. An organ-specific evaluation of 24,771 patients from the trauma register of the DGU. Unfallchirurg. 2008;111(4):232–9. https://doi.org/10.1007/s00113-008-1409-9.
2. Goin G, Massalou D, Bege T, Contargyris C, Avaro JP, Pauleau G, Balandraud P. Feasibility of selective non-operative management for penetrating abdominal trauma in France. J Visc Surg. 2017;154(3):167–74. https://doi.org/10.1016/j.jviscsurg.2016.08.006.
3. Miller KS, McAninch JW. Radiographic assessment of renal trauma: our 15-year experience. J Urol. 1995;154(2 Pt 1):352–5. https://doi.org/10.1097/00005392-199508000-00004.
4. Voelzke BB, Leddy L. The epidemiology of renal trauma. Transl Androl Urol. 2014;3(2):143–9. https://doi.org/10.3978/j.issn.2223-4683.2014.04.11.
5. Kitrey ND, Djakovic N, Hallscheidt P, Kuehhas FE, Lumen N, Serafetinidis E, Sharma DM. EAU Guidelines on Urological Trauma. In: Edn. presented at the EAU Annual Congress Milan 2021. EAU Guidelines Office, Arnhem. 2021. http://uroweb.org/guidelines/compilations-of-all-guidelines/.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献