Rate of Intervention Following Major Renal Trauma in Auckland City: A 5-Year Retrospective Study
Authors List
Tiro, J., Auckland City Hospital, Auckland, New Zealand
Zargar, K., Auckland City Hospital, Auckland, New Zealand
Introduction
Renal Trauma is seen in up to 5% of all trauma cases. There is a trend towards conservative and minimally invasive management of renal trauma in guidelines internationally, however, there is limited evidence on the epidemiology and rate of intervention of Major Renal Trauma in New Zealand.
Aims
This study aimed to investigate the rate of such interventions following Major Renal rauma (MRT) in Auckland City over a 5-year period.
Methods
A retrospective analysis was conducted on patients with MRT (defined as AAST Grade III or higher) who were admitted to hospitals in Auckland City between January 2017 and December 2022. The Primary Outcome was the rate of intervention (Radiological or Surgical). Secondary outcomes included 90-day mortality, transfusion requirement, length of stay, and other injuries.
Results
77 patients with MRT were admitted during the study period. The median age was 34 years and 85.7% were male. 90-day mortality was 2.6%.
Most cases were the result of blunt trauma (93.5%). Falls (45.5%), sporting activities (33.8%) and Motor Vehicle Accidents (14.3%) were the most common mechanisms.
22 patients (28.6%) required intervention for their renal injury. 12 patients (15.9%) underwent retrograde ureteric stent insertion, 10 patients (13%) had embolization by Interventional Radiology, and 3 patients (3.8%) required nephrectomy.
Those with a grade IV/V injury were more likely to require intervention (odds ratio 33.0, 95% confidence interval 6.9, 158.2).
32.4% of patients had other injuries. Rib fractures (20.8%) were most common.
Conclusions
Our study findings demonstrate the need for surgical or radiological intervention in a significant proportion of patients with MRT in Auckland City. The interventions primarily consisted of IR embolization and ureteric stent placement. Majority of cases are the result of blunt trauma, and are commonly associated with other injuries. Given this, an inter-disciplinary approach is important in managing our patients with major renal trauma.
Tiro, J., Auckland City Hospital, Auckland, New Zealand
Zargar, K., Auckland City Hospital, Auckland, New Zealand
Introduction
Renal Trauma is seen in up to 5% of all trauma cases. There is a trend towards conservative and minimally invasive management of renal trauma in guidelines internationally, however, there is limited evidence on the epidemiology and rate of intervention of Major Renal Trauma in New Zealand.
Aims
This study aimed to investigate the rate of such interventions following Major Renal rauma (MRT) in Auckland City over a 5-year period.
Methods
A retrospective analysis was conducted on patients with MRT (defined as AAST Grade III or higher) who were admitted to hospitals in Auckland City between January 2017 and December 2022. The Primary Outcome was the rate of intervention (Radiological or Surgical). Secondary outcomes included 90-day mortality, transfusion requirement, length of stay, and other injuries.
Results
77 patients with MRT were admitted during the study period. The median age was 34 years and 85.7% were male. 90-day mortality was 2.6%.
Most cases were the result of blunt trauma (93.5%). Falls (45.5%), sporting activities (33.8%) and Motor Vehicle Accidents (14.3%) were the most common mechanisms.
22 patients (28.6%) required intervention for their renal injury. 12 patients (15.9%) underwent retrograde ureteric stent insertion, 10 patients (13%) had embolization by Interventional Radiology, and 3 patients (3.8%) required nephrectomy.
Those with a grade IV/V injury were more likely to require intervention (odds ratio 33.0, 95% confidence interval 6.9, 158.2).
32.4% of patients had other injuries. Rib fractures (20.8%) were most common.
Conclusions
Our study findings demonstrate the need for surgical or radiological intervention in a significant proportion of patients with MRT in Auckland City. The interventions primarily consisted of IR embolization and ureteric stent placement. Majority of cases are the result of blunt trauma, and are commonly associated with other injuries. Given this, an inter-disciplinary approach is important in managing our patients with major renal trauma.
