Selective operative management of major blunt renal trauma.
BACKGROUND
We reviewed the management and outcomes of patients at our Level I trauma center suffering major blunt renal trauma diagnosed and staged by CT scan.


METHODS
We retrospectively reviewed the cases of 26 patients with blunt trauma at our institution who were initially hemodynamically stable and diagnosed with grade 4 or 5 renal injuries by CT scan. Patients were broken down into two groups based on whether they were managed conservatively or surgically. Patient characteristics and morbidity were analyzed.


RESULTS
There were 14 patients managed conservatively and 12 patients managed surgically. There was no statistically significant difference in morbidity between the two groups. The only statistically significant predictor of failure of conservative management was a coexisting solid organ intra-abdominal injury.


CONCLUSIONS
Conservative management of major blunt renal trauma is appropriate in hemodynamically stable patients.
Bozeman
Caleb
C
Department of Urology, Louisiana State University-Health Sciences Center, Shreveport, Louisiana 71130, USA. calebbozeman@yahoo.com
Carver
Brett
B
Zabari
Gazi
G
Caldito
Gloria
G
Venable
Dennis
D
D000007:Abdominal Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002648:Child; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007668:Kidney / Q000293:injuries*; D007902:Length of Stay / Q000706:statistics & numerical data; D008145:Louisiana / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D009392:Nephrectomy / Q000706:statistics & numerical data; D018579:Patient Selection; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*