On the black slope: analysis of the course of a blunt renal trauma collective in a winter sports region.

Autor: Deininger C; Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria.; Institute of Tendon and Bone Regeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, Austria., Freude T; Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Wichlas F; Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Kriechbaumer LK; Department of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Deininger SHM; Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Törzsök P; Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Lusuardi L; Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Pallauf M; Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria., Deluca A; Institute of Tendon and Bone Regeneration, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University, Salzburg, Austria., Deininger S; Department of Urology and Andrology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria. Susanne.deininger@mail.de.
Jazyk: angličtina
Zdroj: European journal of trauma and emergency surgery : official publication of the European Trauma Society [Eur J Trauma Emerg Surg] 2022 Jun; Vol. 48 (3), pp. 2125-2133. Date of Electronic Publication: 2021 Dec 16.
DOI: 10.1007/s00068-021-01830-w
Abstrakt: Purpose: The aim of this study was to analyze the injury patterns and clinical course of a winter sport dominated by blunt renal trauma collective.
Methods: Blunt renal trauma cases (N = 106) treated in a Level 1 Trauma Center in Austria were analyzed.
Results: We encountered 12.3% grade 1, 10.4% grade 2, 32.1% grade 3, 38.7% grade 4 and 6.6% grade 5 renal traumata classified according to the American Association for the Surgery of Trauma (AAST). The mechanisms of injury (MOI) did not have an influence on the frequency of HG trauma (i.e., grade 4 and 5). No concomitant injuries (CIs) were found in 57.9% of patients. The number of patients without CIs was significantly higher in the sports associated trauma group compared to other MOIs (p < 0.01). In 94.3% the primary treatment was a non-operative management (NOM) including 56.6% conservative, 34.0% endourological, and 3.8% interventional therapies. A follow-up computed tomography (FU-CT) was performed in 81.1%, 3.3 days after trauma. After FU-CT, the primary therapy was changed in 11.4% of cases (grade ≥ 3). Comparing the Hb loss between the patients with grade 3 and 4 kidney trauma with and without revision surgery, we find a significantly increased Hb loss within the first 96 h after the trauma in the group with a needed change of therapy (p < 0.0001). The overall rate of nephrectomy (primary or secondary) was 9.4%. Independent predictors of nephrectomy were HG trauma (p < 0.01), age (p < 0.05), and sex (p < 0.05). The probability of nephrectomy was lower with (winter) sports-associated trauma (p < 0.1).
Conclusions: Sports-associated blunt renal trauma is more likely to occur isolated, and has a lower risk of severe outcomes, compared to other trauma mechanisms. NOM can successfully be performed in over 90% of all trauma grades.
(© 2021. The Author(s).)
Databáze: MEDLINE
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