Kidney Injuries at a Level 1 Trauma Center

Orlando—Elmhurst Hospital Center at the Icahn School of Medicine in Queens, New York, is a level 1 trauma center. Approximately 3% of all trauma admissions at the center are renal trauma cases; among patients who sustain abdominal trauma, as many as 10% of trauma admissions involve renal trauma.

Researchers at the center, led by Jayaramakrishna Depa, MD, conducted a retrospective review to examine the epidemiology of renal trauma over the past decade; they also sought to identify any changes in acute kidney function associated with renal trauma. Results of the analysis were reported during a poster session at the NKF 2017 Spring Clinical Meetings in a poster titled Review of Kidney Injuries and Subsequent Function at a Level 1 Trauma Center over a 13-Year Span.

The review included the electronic health records for all trauma patients with kidney injury treated at Elmhurst Hospital Center from January 2004 through October 2016. Collected data included age, sex, mechanisms of injury, length of stay, and mortality.

Computed tomography scans of kidney injury were also examined to grade injury severity. Grade 1 was defined as contusion or non-enlarging injury; grade 2 as superficial laceration <1 cm in depth not involving the collecting system; grade 3 as laceration >1 cm without extension into the renal pelvis; grade 4 as laceration extending to the renal pelvis or a vascular injury; and grade 5 as a shattered kidney.

The study included 71 patients: 61 adults and 10 pediatric patients. Overall, mean age was 31.8 years, and 87% were male (n=62). The most common kidney injury was blunt trauma (76%, n=54). Twenty-five (64.1%) were non-serious grade (grade 1-3) and 14 (35.9%) were serious grade (grade 4-5). Among patients with penetrating trauma (n=17), nine had non-serious grade injury (grade 1-3) and five had serious grade injury (grade 4-5).

Length of stay for blunt trauma was significantly longer than for penetrating injury (21.04 days vs 7.14 days) (P=.009). There was no change in creatinine levels between admission and discharge in either group.

Source: Depa C, Rajnish I, Ahlborn D, Adjei-Bosompem T, Kalosza B, Coritsidis GN. Review of kidney injuries and subsequent function at a level 1 trauma center over a 13-year span. Poster presented at the National Kidney Foundation 2017 Spring Clinical Meetings, April 21, 2017, Orlando, Florida.