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Independent predictors of mortality for patients with traumatic renal injury

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Abstract

Purpose

To investigate the parameters of renal trauma, including emergent intervention type, that predict the mortality of patients with traumatic renal injury.

Methods

A retrospective database analysis was performed on patients who sustained a traumatic renal parenchymal injury identified by the 2017 National Trauma Data Bank. Data were analyzed to identify differences in hospital length of stay, ER and hospital disposition, and mortality based on patient age, gender, race, Injury Severity Score, renal injury grade, and need for emergent intervention (angioembolization versus open surgery). Logistic regression was used to correlate intervention type and trauma parameters to mortality.

Results

A total of 4,876 of 1,004,440 trauma patients (0.49%) had a traumatic renal injury. Of those, 220 (4.5%) underwent an emergent intervention—29 (0.59%) angioembolization and 191 (3.9%) open renal surgery. 83 patients with a blunt renal trauma (2.0%) underwent renal intervention, whereas 136 (21.0%) with a penetrating injury required a procedure. Forty-five of the 220 patients (20.5%) who had a renal intervention died, while 377 of 4,656 (8.1%) who did not have an intervention died. Multiple logistic regression identified black race, age > 45 years, penetrating trauma, and ISS > 15 to be independent predictors of mortality. Neither angioembolization nor open renal surgery was associated with a significantly higher likelihood of mortality in the multivariable model.

Conclusion

While procedural interventions are associated with higher mortality for patients with traumatic renal injury, other factors, such as race, age, trauma type, and injury severity may be more predictive of death under care.

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Notes

  1. 0TQ00ZZ, 0TQ10ZZ: Repair Right and Left Kidney, Open Approach; 0TQ30ZZ, 0TQ40ZZ: Repair Right and Left Kidney Pelvis, Open Approach; 0TT00ZZ, 0TT10ZZ: Resection of Right and Left Kidney, Open Approach; 0TB00ZX, 0TB10ZZ: Excision of Right and Left Kidney, Open Approach; 0TD00ZZ, 0TD10ZZ: Extraction of Right and Left Kidney, Open Approach.

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Authors and Affiliations

  1. Columbia-Bassett Program, Bassett Healthcare, Cooperstown, NY, USA

    Patrick Ho

  2. Division of Urology, Department of Surgery, Bassett Healthcare, Cooperstown, NY, USA

    Nicholas J. Hellenthal

Authors
  1. Patrick Ho
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  2. Nicholas J. Hellenthal
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Contributions

NJH: project development, data management, data analysis, manuscript writing. PH: project development, data analysis, manuscript writing.

Corresponding author

Correspondence to Patrick Ho.

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The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This is a retrospective analysis of a national trauma data registry that contains de-identified information.

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No identifying details of individuals are included in this manuscript.

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Ho, P., Hellenthal, N.J. Independent predictors of mortality for patients with traumatic renal injury. World J Urol 39, 3685–3690 (2021). https://doi.org/10.1007/s00345-020-03552-x

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  • DOI: https://doi.org/10.1007/s00345-020-03552-x

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