Implementation of a clinical guideline for nonoperative management of isolated blunt renal injury in children
| Autor: | Martin S. Keller, Stephanie J. Treon, Michele Herndon, Tamar Levene, Allie E. Steinberger, Nicole A. Wilson, Connor Fairfax |
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| Rok vydání: | 2021 |
| Předmět: |
CBC
complete blood count medicine.medical_specialty RD1-811 AAST American Association for the Surgery of Trauma DMSA dimercaptosuccinic acid MAG3 mercaptuacetyltriglycine scan Trauma registry Article law.invention Blunt Renal injury law ACS American College of Surgeons SPECT single-photon emission computerized tomography ROUT robust regression with outlier detection Medicine Nonoperative management Urinary catheter business.industry Guideline medicine.disease ICU intensive care unit Intensive care unit CT computed tomography VCUG voiding cystourethrogram Emergency medicine CAUTI catheter-associated urinary tract infections Surgery CDC Centers for Disease Control and Prevention (CDC) business LOS length of stay Pediatric trauma |
| Zdroj: | Surgery Open Science, Vol 5, Iss, Pp 19-24 (2021) Surgery Open Science |
| ISSN: | 2589-8450 |
| DOI: | 10.1016/j.sopen.2021.04.003 |
| Popis: | Background The aim was to evaluate the impact of a standardized nonoperative management protocol by comparing patients with isolated blunt renal injury before and after implementation. Methods We retrospectively reviewed the trauma registry at our Level 1 pediatric trauma center. We compared consecutive patients (≤ 18 years) managed nonoperatively for blunt renal injury Pre (1/2010–9/2014) and Post (10/2014–3/2020) implementation of a clinical guideline. Outcomes included length of stay, intensive care unit admission, urinary catheter use, and imaging studies. Results We included 48 patients with isolated blunt renal injuries (29 Pre, 19 Post). There were no differences in age, sex, injury grade, or mechanism (P > .05). Postprotocol had decreased length of stay (P = .040), intensive care unit admissions (P = .015), urinary catheter use (P = .031), and ionizing radiation imaging (P Highlights • Implementation of a standardized nonoperative management protocol for pediatric patients with isolated blunt renal injury improved outcomes and resource utilization. • Protocol implementation was associated with decreased length of stay, ICU admissions, urinary catheter use, and ionizing radiation imaging. • There were no differences in demographics, mechanism, or grade of injury between pre- and postprotocol groups. |
| Databáze: | OpenAIRE |
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