Journal article
High-grade renal injuries are often isolated in sports-related trauma
Injury, Vol.46(7), pp.1245-1249
07/2015
DOI: 10.1016/j.injury.2015.02.008
PMCID: PMC4896140
PMID: 25769197
Abstract
Most high-grade renal injuries (American Association for Surgery of Trauma (AAST) grades III–V) result from motor vehicle collisions associated with numerous concomitant injuries. Sports-related blunt renal injury tends to have a different mechanism, a solitary blow to the flank. We hypothesized that high-grade renal injury is often isolated in sports-related renal trauma.
We identified patients with AAST grades III–V blunt renal injuries from four level 1 trauma centres across the United States between 1/2005 and 1/2014. Patients were divided into “Sport” or “Non-sport” related groups. Outcomes included rates of hypotension (systolic blood pressure <90mm Hg), tachycardia (>110bpm), concomitant abdominal injury, and procedural/surgical intervention between sports and non-sports related injury.
320 patients met study criteria. 18% (59) were sports-related injuries with the most common mechanisms being skiing, snowboarding and contact sports (25%, 25%, and 24%, respectively). Median age was 24 years for sports and 30 years for non-sports related renal injuries (p=0.049). Males were more commonly involved in sports related injuries (85% vs. 72%, p=0.011). Median injury severity score was lower for sports related injuries (10 vs. 27, p<0.001). There was no difference in renal abbreviated injury scale scores. Sports related trauma was more likely to be isolated without other significant injury (69% vs. 39% (p<0.001)). Haemodynamic instability was present in 40% and 51% of sports and non-sports renal injuries (p=0.30). Sports injuries had lower transfusion (7% vs. 47%, p<0.001) and lower mortality rates (0% vs. 6%, p=0.004). There was no difference in renal-specific procedural interventions between the two groups (17% sports vs. 18% non-sports, p=0.95).
High-grade sports-related blunt renal trauma is more likely to occur in isolation without other abdominal or thoracic injuries and clinicians must have a high suspicion of renal injury with significant blows to the flank during sports activities.
Details
- Title: Subtitle
- High-grade renal injuries are often isolated in sports-related trauma
- Creators
- Darshan P Patel - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, United StatesJeffrey D Redshaw - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, United StatesBenjamin N Breyer - Department of Urology, University of California San Francisco, San Francisco, CA, United StatesThomas G Smith - Department of Urology, Baylor College of Medicine, Houston, TX, United StatesBradley A Erickson - Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA, United StatesSarah D Majercik - Division of Trauma and Surgical Critical Care, Department of Surgery, Intermountain Medical Center, Murray, UT, United StatesThomas W Gaither - Department of Urology, University of California San Francisco, San Francisco, CA, United StatesJames R Craig - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, United StatesScott Gardner - Division of Trauma and Surgical Critical Care, Department of Surgery, Intermountain Medical Center, Murray, UT, United StatesAngela P Presson - Division of Epidemiology, University of Utah, Salt Lake City, UT, United StatesChong Zhang - Division of Epidemiology, University of Utah, Salt Lake City, UT, United StatesJames M Hotaling - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, United StatesWilliam O Brant - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, United StatesJeremy B Myers - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, United States
- Resource Type
- Journal article
- Publication Details
- Injury, Vol.46(7), pp.1245-1249
- DOI
- 10.1016/j.injury.2015.02.008
- PMID
- 25769197
- PMCID
- PMC4896140
- NLM abbreviation
- Injury
- ISSN
- 0020-1383
- eISSN
- 1879-0267
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 07/2015
- Academic Unit
- Urology
- Record Identifier
- 9984051766602771
Metrics
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