Citation

Steinberger AE, Wilson NA, Fairfax C, Treon SJ, Herndon M, Levene TL, Keller MS. Surg. Open Sci. 2021; 5: 19-24.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.sopen.2021.04.003

PMID

34337373

Abstract

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 < .001).

CONCLUSION: These data suggest improved outcomes and resource utilization following implementation of a nonoperative management protocol of pediatric isolated blunt renal injuries.

Language: en

Keywords

CT, computed tomography; AAST, American Association for the Surgery of Trauma; ACS, American College of Surgeons; CAUTI, catheter-associated urinary tract infections; CBC, complete blood count; CDC, Centers for Disease Control and Prevention (CDC); DMSA, dimercaptosuccinic acid; ICU, intensive care unit; LOS, length of stay; MAG3, mercaptuacetyltriglycine scan; ROUT, robust regression with outlier detection; SPECT, single-photon emission computerized tomography; VCUG, voiding cystourethrogram