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Contemporary management of penetrating renal trauma - A national analysis

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Harvard

El Hechi, MW, Nederpelt, C, Kongkaewpaisan, N, Bonde, A, Kokoroskos, N, Breen, K, Nasser, A, Saillant, NN, Kaafarani, HMA, Velmahos, GC & Mendoza, AE 2020, 'Contemporary management of penetrating renal trauma - A national analysis' Injury, vol. 51, no. 1, pp. 32-38. https://doi.org/10.1016/j.injury.2019.09.006

APA

El Hechi, M. W., Nederpelt, C., Kongkaewpaisan, N., Bonde, A., Kokoroskos, N., Breen, K., ... Mendoza, A. E. (2020). Contemporary management of penetrating renal trauma - A national analysis. Injury, 51(1), 32-38. https://doi.org/10.1016/j.injury.2019.09.006

CBE

El Hechi MW, Nederpelt C, Kongkaewpaisan N, Bonde A, Kokoroskos N, Breen K, Nasser A, Saillant NN, Kaafarani HMA, Velmahos GC, Mendoza AE. 2020. Contemporary management of penetrating renal trauma - A national analysis. Injury. 51(1):32-38. https://doi.org/10.1016/j.injury.2019.09.006

MLA

Vancouver

El Hechi MW, Nederpelt C, Kongkaewpaisan N, Bonde A, Kokoroskos N, Breen K et al. Contemporary management of penetrating renal trauma - A national analysis. Injury. 2020 Jan;51(1):32-38. https://doi.org/10.1016/j.injury.2019.09.006

Author

El Hechi, Majed W ; Nederpelt, Charlie ; Kongkaewpaisan, Napaporn ; Bonde, Alexander ; Kokoroskos, Nikolaos ; Breen, Kerry ; Nasser, Ahmed ; Saillant, Noelle N ; Kaafarani, Haytham M A ; Velmahos, George C ; Mendoza, April E. / Contemporary management of penetrating renal trauma - A national analysis. In: Injury. 2020 ; Vol. 51, No. 1. pp. 32-38.

Bibtex

@article{70145262e4bb4a88afbe0e49c557c727,
title = "Contemporary management of penetrating renal trauma - A national analysis",
abstract = "INTRODUCTION: Indications for nonoperative management (NOM) after penetrating renal injury remain ill-defined. Using a national database, we sought to describe the experience of operative and nonoperative management in the United States and retrospectively examine risk factors for failure of NOM.MATERIALS AND METHODS: The TQIP database 2010-2016 was used to identify patients with penetrating renal trauma. Outcomes of patients treated with an immediate operation (IO) and NOM are described. Failure of NOM was defined as the need for a renal operation after 4 h from arrival. Univariate then multivariable regression analyses were performed to identify predictors of NOM failure.RESULTS: Out of 8139 patients with kidney trauma, 1,842 had a penetrating mechanism of injury and were included. Of those, 89{\%} were male, median age was 28 years, and 330 (18{\%}) were offered NOM. Compared to IO, NOM patients were less likely to have gunshot wound (59{\%} vs 89{\%} p < 0.001) or high-grade renal injuries [AAST 4-5] (48{\%} vs 76{\%}, p < 0.001). Lower rates of in-hospital complications and shorter ICU and hospital stays were observed in the NOM group. NOM failed in 26 patients (8{\%}). Independent predictors of NOM failure included a concomitant abdominal injury (OR = 3.99, 95{\%} CI 1.03-23.23, p = 0.044), and every point increase in AAST grade (OR = 2.43, 95{\%} CI 1.27-5.21, p = 0.005).CONCLUSIONS: NOM is highly successful in selected patients. Concomitant abdominal injuries and higher grade AAST injuries predict NOM failure and should be considered when selecting patients for IO or NOM.",
keywords = "Injury, Kidney, Management, Nonoperative, Penetrating, Renal, Trauma",
author = "{El Hechi}, {Majed W} and Charlie Nederpelt and Napaporn Kongkaewpaisan and Alexander Bonde and Nikolaos Kokoroskos and Kerry Breen and Ahmed Nasser and Saillant, {Noelle N} and Kaafarani, {Haytham M A} and Velmahos, {George C} and Mendoza, {April E}",
note = "Copyright {\circledC} 2019 Elsevier Ltd. All rights reserved.",
year = "2020",
month = "1",
doi = "10.1016/j.injury.2019.09.006",
language = "English",
volume = "51",
pages = "32--38",
journal = "Injury",
issn = "0020-1383",
publisher = "Elsevier Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Contemporary management of penetrating renal trauma - A national analysis

AU - El Hechi, Majed W

AU - Nederpelt, Charlie

AU - Kongkaewpaisan, Napaporn

AU - Bonde, Alexander

AU - Kokoroskos, Nikolaos

AU - Breen, Kerry

AU - Nasser, Ahmed

AU - Saillant, Noelle N

AU - Kaafarani, Haytham M A

AU - Velmahos, George C

AU - Mendoza, April E

N1 - Copyright © 2019 Elsevier Ltd. All rights reserved.

PY - 2020/1

Y1 - 2020/1

N2 - INTRODUCTION: Indications for nonoperative management (NOM) after penetrating renal injury remain ill-defined. Using a national database, we sought to describe the experience of operative and nonoperative management in the United States and retrospectively examine risk factors for failure of NOM.MATERIALS AND METHODS: The TQIP database 2010-2016 was used to identify patients with penetrating renal trauma. Outcomes of patients treated with an immediate operation (IO) and NOM are described. Failure of NOM was defined as the need for a renal operation after 4 h from arrival. Univariate then multivariable regression analyses were performed to identify predictors of NOM failure.RESULTS: Out of 8139 patients with kidney trauma, 1,842 had a penetrating mechanism of injury and were included. Of those, 89% were male, median age was 28 years, and 330 (18%) were offered NOM. Compared to IO, NOM patients were less likely to have gunshot wound (59% vs 89% p < 0.001) or high-grade renal injuries [AAST 4-5] (48% vs 76%, p < 0.001). Lower rates of in-hospital complications and shorter ICU and hospital stays were observed in the NOM group. NOM failed in 26 patients (8%). Independent predictors of NOM failure included a concomitant abdominal injury (OR = 3.99, 95% CI 1.03-23.23, p = 0.044), and every point increase in AAST grade (OR = 2.43, 95% CI 1.27-5.21, p = 0.005).CONCLUSIONS: NOM is highly successful in selected patients. Concomitant abdominal injuries and higher grade AAST injuries predict NOM failure and should be considered when selecting patients for IO or NOM.

AB - INTRODUCTION: Indications for nonoperative management (NOM) after penetrating renal injury remain ill-defined. Using a national database, we sought to describe the experience of operative and nonoperative management in the United States and retrospectively examine risk factors for failure of NOM.MATERIALS AND METHODS: The TQIP database 2010-2016 was used to identify patients with penetrating renal trauma. Outcomes of patients treated with an immediate operation (IO) and NOM are described. Failure of NOM was defined as the need for a renal operation after 4 h from arrival. Univariate then multivariable regression analyses were performed to identify predictors of NOM failure.RESULTS: Out of 8139 patients with kidney trauma, 1,842 had a penetrating mechanism of injury and were included. Of those, 89% were male, median age was 28 years, and 330 (18%) were offered NOM. Compared to IO, NOM patients were less likely to have gunshot wound (59% vs 89% p < 0.001) or high-grade renal injuries [AAST 4-5] (48% vs 76%, p < 0.001). Lower rates of in-hospital complications and shorter ICU and hospital stays were observed in the NOM group. NOM failed in 26 patients (8%). Independent predictors of NOM failure included a concomitant abdominal injury (OR = 3.99, 95% CI 1.03-23.23, p = 0.044), and every point increase in AAST grade (OR = 2.43, 95% CI 1.27-5.21, p = 0.005).CONCLUSIONS: NOM is highly successful in selected patients. Concomitant abdominal injuries and higher grade AAST injuries predict NOM failure and should be considered when selecting patients for IO or NOM.

KW - Injury

KW - Kidney

KW - Management

KW - Nonoperative

KW - Penetrating

KW - Renal

KW - Trauma

U2 - 10.1016/j.injury.2019.09.006

DO - 10.1016/j.injury.2019.09.006

M3 - Journal article

VL - 51

SP - 32

EP - 38

JO - Injury

JF - Injury

SN - 0020-1383

IS - 1

ER -

ID: 58123539