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Journal Article

Citation

Bjurlin MA, Fantus RJ, Mellett MM, Fantus RJ, Villines D. J. Urol. 2014; 192(4): 1131-1136.

Affiliation

Department of Research, Advocate Health, Chicago, IL, 60657.

Copyright

(Copyright © 2014, American Urological Association, Publisher Elsevier Publishing)

DOI

10.1016/j.juro.2014.04.093

PMID

24846798

Abstract

PURPOSE: Motor vehicle collisions (MVCs) are the most common cause of blunt genitourinary trauma. We compared renal injuries with no protective device to those with seat belts and/or airbags utilizing the National Trauma Data Bank (NTDB). Our primary endpoint was a reduction in high-grade renal injuries (grades III-V) with a secondary endpoint of reduction in nephrectomy rate.

MATERIALS AND METHODS: The NTDB research datasets, admission year 2010, 2011, and 2012, were queried for MVC occupants with renal injury. Subjects were stratified by protective device and airbag deployment. Abbreviated Injury Score was converted to American Association for the Surgery of Trauma renal injury grade and nephrectomy rates were evaluated. Intergroup comparisons were analyzed for renal injury grades, nephrectomy, length of stay, and mortality with chi-square or one-way ANOVA. Protective device relative risk reduction was determined.

RESULTS: A review of 466,028 MVCs revealed 3,846 renal injuries. Injured occupants without a protective device had a higher rate of high grade renal injury (45.1%) compared to those with seat belts (39.9%, p=0.008), airbags (42.3%, p=0.317), and seat belts with airbags (34.7%, p<0.001). Seat belts (20.0%, p<0.001), airbags (10.5% p<0.001), and seat belts with airbags (13.3%, p<0.001) reduced the rate of nephrectomy compared to no protective device (56.2%). The combination of seatbelts and airbags also reduced total hospital length of stay (p<0.001) and ICU days (p=0.005). Relative risk reduction of high-grade renal injuries (23.1%) and nephrectomy (39.9%) were highest for combined protective devices.

CONCLUSIONS: Occupants of MVCs with protective devices have reduced rates of high-grade renal injury and nephrectomy. Reduction appears most pronounced with the combination of seat belts and airbags.


Language: en

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