Citation

Grimsby GM, Voelzke B, Hotaling J, Sorensen MD, Koyle M, Jacobs MA. J. Urol. 2014; 192(5): 1498-1502.

Affiliation

Division of Pediatric Urology, Department of Urology, UT Southwestern Medical Center, Dallas, TX. Electronic address: Micah.Jacobs@Childrens.com.

Copyright

(Copyright © 2014, American Urological Association, Publisher Elsevier Publishing)

DOI

10.1016/j.juro.2014.05.103

PMID

24907442

Abstract

PURPOSE: There is a lack of national data describing the demographics and nature of pediatric renal trauma. The goal of this study was to use the National Trauma Data Bank to analyze the method and grade of renal injury, demographic, and treatment characteristics of pediatric renal trauma patients.

MATERIALS AND METHODS: Renal injuries were identified by Abbreviated Injury Scale codes and converted to American Association for the Surgery of Trauma (AAST) renal injury grades. Patients were stratified by age (0-1, 2-4, 5-14, and 15-18) for more specific analyses of mechanism and grade of injury. Data reviewed included mechanism and grade of renal injury, demographics, and setting and type of treatment.

RESULTS: 2213 pediatric renal injuries were converted to AAST grade. Mean age at time of injury was 13.7 years old (SD 4.4) with 2089 (94%) patients between the ages of 5 and 18. 79% of injuries were grades I, II or III. Penetrating injury accounted for less than 10% of all pediatric renal injuries. A majority of patients were admitted to university hospitals (57%) with a dedicated trauma service (73%) and only 12% of patients were admitted to a children's hospital. 122 nephrectomies were performed (5.5%).

CONCLUSION: A majority of renal trauma in children is low grade, blunt in nature, more common in children over the age of 5, and the vast majority treated at adult hospitals. Though a majority of patients were managed conservatively, the rate of nephrectomy was 3 times higher at adult hospitals versus pediatric centers.

Language: en