title: Demographics of pediatric renal trauma.
abstract: OBJECTIVE
  There is a lack of national data describing the demographics and nature of pediatric renal trauma. We used the National Trauma Data Bank to analyze mechanisms and grades of injury, demographics and treatment characteristics of pediatric renal trauma cases.
  
  
  METHODS
  Renal injuries were identified by Abbreviated Injury Scale codes and converted to American Association for the Surgery of Trauma renal injury grades. Patients were stratified by age (0 to 1, 2 to 4, 5 to 14 and 15 to 18 years) for more specific analyses of mechanisms and grades of injury. Data reviewed included mechanisms and grades of renal injury, demographics, and setting and type of treatment.
  
  
  RESULTS
  A total of 2,213 pediatric renal injuries were converted to American Association for the Surgery of Trauma grade. Mean ± SD age at injury was 13.7 ± 4.4 years, with 2,089 patients (94%) being 5 to 18 years old. Of the injuries 79% were grade I, II or III. Penetrating injury accounted for less than 10% of all pediatric renal injuries. A majority of patients (57%) were admitted to university hospitals with a dedicated trauma service (73%) and only 12% of patients were admitted to a pediatric hospital. A total of 122 nephrectomies (5.5%) were performed.
  
  
  CONCLUSIONS
  Most renal trauma in children is low grade, is blunt in nature and occurs after age 5 years. The majority of these cases are managed at adult hospitals. Although most patients are treated conservatively, the rate of nephrectomy is 3 times higher at adult hospitals than at pediatric centers.
authors.affiliation: Division of Pediatric Urology, Department of Urology, UT Southwestern Medical Center, Dallas, Texas.
authors.forename: Gwen M
authors.initials: GM
authors.lastname: Grimsby
authors.affiliation: Department of Urology, University of Washington School of Medicine, Seattle, Washington.
authors.forename: Bryan
authors.initials: B
authors.lastname: Voelzke
authors.affiliation: Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, Utah.
authors.forename: James
authors.initials: J
authors.lastname: Hotaling
authors.affiliation: Department of Urology, University of Washington School of Medicine, Seattle, Washington; Division of Urology, Department of Veterans Affairs Medical Center, Seattle, Washington.
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Sorensen
authors.affiliation: University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Koyle
authors.affiliation: Division of Pediatric Urology, Department of Urology, UT Southwestern Medical Center, Dallas, Texas. Electronic address: Micah.Jacobs@Childrens.com.
authors.forename: Micah A
authors.initials: MA
authors.lastname: Jacobs
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000293:injuries*; D008297:Male; D011159:Population Surveillance; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology
keywords: kidney; pediatrics; trauma centers; trauma severity indices; wounds and injuries