Who Is at Risk of Death after Renal Trauma? An Analysis of Thirty-Day Mortality after 1,799 Cases of Renal Trauma.

Autor:	Baboudjian M; Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception Academic Hospital, Marseille, France., Lebacle C; Department of Urology, University of Paris Sud, CHU Bicetre, Paris, France., Gondran-Tellier B; Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception Academic Hospital, Marseille, France., Hutin M; Department of Urology, University of Montpellier, Montpellier, France., Olivier J; Department of Urology, University of Lille, Lille, France., Ruggiero M; Department of Urology, University of Paris Sud, CHU Bicetre, Paris, France., Panayotopoulos P; Department of Urology, University of Angers, Angers, France., Dominique I; Department of Urology, University of Lyon, Lyon, France., Millet C; Department of Urology, University of Clermont-Ferrand, Clermont-Ferrand, France., Bergerat S; Department of Urology, University of Strasbourg, Strasbourg, France., Freton L; Department of Urology, University of Rennes, Rennes, France., Betari R; Department of Urology, University of Amiens, Amiens, France., Matillon X; Department of Urology, University of Lyon, Lyon, France., Chebbi A; Department of Urology, University of Rouen, Rouen, France., Caes T; Department of Urology, University of Lille, Lille, France., Patard PM; Department of Urology, University of Toulouse, Toulouse, France., Szabla N; Department of Urology, University of Caen, Caen, France., Sabourin L; Department of Urology, University of Clermont-Ferrand, Clermont-Ferrand, France., Dariane C; Department of Urology, University of Paris Descartes, Paris, France., Rizk J; Department of Urology, University of Lille, Lille, France., Madec FX; Department of Urology, University of Nantes, Nantes, France., Nouhaud FX; Department of Urology, University of Rouen, Rouen, France., Rod X; Department of Urology, University of Nantes, Nantes, France., Fiard G; Department of Urology, University of Grenoble, Grenoble, France., Pradere B; Department of Urology, University of Tours, Tours, France., Peyronnet B; Department of Urology, University of Rennes, Rennes, France.
Jazyk:	angličtina
Zdroj:	Urologia internationalis [Urol Int] 2023; Vol. 107 (2), pp. 165-170. Date of Electronic Publication: 2022 Apr 07.
DOI:	10.1159/000521554
Abstrakt:	Introduction: The aim of the study was to report the 30-day mortality (30DM) after renal trauma and identify the risk factors associated with death. Methods: The TRAUMAFUF project was a retrospective multi-institutional study including all patients with renal trauma admitted to 17 French hospitals between 2005 and 2015. The included population focused on patients of all age groups who underwent renal trauma during the study period. The primary outcome was death within 30 days following trauma. The multivariate logistic regression model with a stepwise backward elimination was used to identify predictive factors of 30DM. Results: Data on 1,799 renal trauma were recorded over the 10-year period. There were 59 deaths within 30 days of renal trauma, conferring a 30DM rate of 3.27%. Renal trauma was directly involved in 5 deaths (8.5% of all deaths, 0.3% of all renal trauma). Multivariate stepwise logistic regression analysis revealed that age >40 years (odds ratio [OR] 2.18; 95% confidence interval [CI]: 1.20-3.99; p = 0.01), hemodynamic instability (OR 4.67; 95% CI: 2.49-9; p < 0.001), anemia (OR 3.89; 95% CI: 1.94-8.37; p < 0.001), bilateral renal trauma (OR 6.77; 95% CI: 2.83-15.61; p < 0.001), arterial contrast extravasation (OR 2.09; 95% CI: 1.09-3.96; p = 0.02), and concomitant visceral and bone injuries (OR 6.57; 95% CI: 2.41-23.14; p < 0.001) were independent predictors of 30DM. Conclusion: Our large multi-institutional study supports that the 30DM of 3.27% after renal trauma is due to the high degree of associated injuries and was rarely a consequence of renal trauma alone. Age >40 years, hemodynamic instability, anemia, bilateral renal trauma, arterial contrast extravasation, and concomitant visceral and bone lesions were predictors of death. These results can help clinicians to identify high-risk patients. (© 2022 S. Karger AG, Basel.)
Databáze:	MEDLINE
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