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Characteristics and outcomes of pediatric blunt renal trauma: a nationwide cohort study in Japan

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to describe epidemiologic features of pediatric blunt renal trauma.

Methods

We performed a retrospective analysis using the Japan Trauma Data Bank over 15 years. We included patients younger than 18 years with blunt renal trauma. We analyzed temporal trends and variations across age groups in patient characteristics, intervention, and in-hospital mortality. We also assessed factors associated with in-hospital mortality.

Results

We identified 435 pediatric patients with blunt renal trauma. Their median age was 14 years and median Injury Severity Score (ISS) was 17. The most common mechanism of injury was traffic accident in all age groups. Nephrectomy was performed in 3.2%, and the overall in-hospital mortality was 4.6%, both of which showed decreasing trends. The most common mechanism of injury by age group was a pedestrian accident in infants/toddlers/preschoolers (43.5%), pedestrian accident in middle childhood (18.5%), bicycle accident in young teens (24.7%), and motorcycle accident in teenagers (41.2%). Sports-related injury was common in young teens (23.3%) and teenagers (15.2%). Factors such as ISS, shock, concomitant injury, and nephrectomy were associated with high in-hospital mortality.

Conclusions

We described decreasing trends in nephrectomy and in-hospital mortality in pediatric blunt renal trauma and found traffic accident and sports-related injury were common in the pediatric population in Japan.

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Data availability

The data that support the findings of this study are available from the JTDB, but the availability of these data is restricted.

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Acknowledgements

The authors gratefully acknowledge the emergency medical service personnel, nurses, emergency physicians, and healthcare workers who participated in the JTDB. This article was supported by the Clinical Investigator’s Research Project at Osaka University Graduate School of Medicine.

Funding

This study was supported by a grant from the Osaka Kidney Foundation (OKF 21-0007).

Author information

Authors and Affiliations

  1. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Shunichiro Nakao, Yusuke Katayama, Tomoya Hirose, Jotaro Tachino, Yuko Nakagawa & Takeshi Shimazu

  2. Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita, Japan

    Atsushi Hirayama

  3. Department of Acute Medicine and Critical Care Medical Center, Osaka National Hospital, National Hospital Organization, Osaka, Japan

    Kenichiro Ishida

  4. Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan

    Yutaka Umemura, Takeyuki Kiguchi & Takeshi Shimazu

  5. Kyoto University Health Service, Kyoto, Japan

    Takeyuki Kiguchi

  6. Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Tasuku Matsuyama

  7. Department of Food Science, Faculty of Home Economics, Otsuma Women’s University, Tokyo, Japan

    Kosuke Kiyohara

  8. Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan

    Tetsuhisa Kitamura

Authors
  1. Shunichiro Nakao
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  2. Yusuke Katayama
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  3. Atsushi Hirayama
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  4. Tomoya Hirose
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  5. Kenichiro Ishida
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  6. Yutaka Umemura
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  7. Jotaro Tachino
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  8. Takeyuki Kiguchi
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  9. Tasuku Matsuyama
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  10. Kosuke Kiyohara
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  11. Tetsuhisa Kitamura
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  12. Yuko Nakagawa
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  13. Takeshi Shimazu
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Contributions

SN conceived the study. SN and AH participated in the data curation. SN, YK, and TK structured the methods and the statistical analysis. SN prepared the manuscript. SN, YK, TK, TH, JT, KI, TK, YU, TM, and KK performed the data interpretation. All authors critically reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Shunichiro Nakao.

Ethics declarations

Conflicts of interest

All the authors have no conflict of interest to declare.

Ethical approval

The protocol was approved by the Ethics Committee of Osaka University as the corresponding institution. The requirement for informed consent of patients was waived.

Consent to participate

Since it is a retrospective analysis of anonymous data, according to the ethics committee dispositions, no informed consent was needed.

Consent for publication

Since it is a retrospective study, according to the ethics committee dispositions, no informed consent was needed.

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Cite this article

Nakao, S., Katayama, Y., Hirayama, A. et al. Characteristics and outcomes of pediatric blunt renal trauma: a nationwide cohort study in Japan. Eur J Trauma Emerg Surg 48, 2047–2057 (2022). https://doi.org/10.1007/s00068-021-01795-w

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  • DOI: https://doi.org/10.1007/s00068-021-01795-w

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