Author(s): Patel DP, Redshaw JD, Breyer BN, Smith TG, Erickson BA,
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Abstract INTRODUCTION: Most high-grade renal injuries (American Association for Surgery of Trauma (AAST) grades III-V) result from motor vehicle collisions associated with numerous concomitant injuries. Sports-related blunt renal injury tends to have a different mechanism, a solitary blow to the flank. We hypothesized that high-grade renal injury is often isolated in sports-related renal trauma. MATERIAL AND METHODS: We identified patients with AAST grades III-V blunt renal injuries from four level 1 trauma centres across the United States between 1/2005 and 1/2014. Patients were divided into "Sport" or "Non-sport" related groups. Outcomes included rates of hypotension (systolic blood pressure <90mm Hg), tachycardia (>110bpm), concomitant abdominal injury, and procedural/surgical intervention between sports and non-sports related injury. RESULTS: 320 patients met study criteria. 18\% (59) were sports-related injuries with the most common mechanisms being skiing, snowboarding and contact sports (25\%, 25\%, and 24\%, respectively). Median age was 24 years for sports and 30 years for non-sports related renal injuries (p=0.049). Males were more commonly involved in sports related injuries (85\% vs. 72\%, p=0.011). Median injury severity score was lower for sports related injuries (10 vs. 27, p<0.001). There was no difference in renal abbreviated injury scale scores. Sports related trauma was more likely to be isolated without other significant injury (69\% vs. 39\% (p<0.001)). Haemodynamic instability was present in 40\% and 51\% of sports and non-sports renal injuries (p=0.30). Sports injuries had lower transfusion (7\% vs. 47\%, p<0.001) and lower mortality rates (0\% vs. 6\%, p=0.004). There was no difference in renal-specific procedural interventions between the two groups (17\% sports vs. 18\% non-sports, p=0.95). CONCLUSIONS: High-grade sports-related blunt renal trauma is more likely to occur in isolation without other abdominal or thoracic injuries and clinicians must have a high suspicion of renal injury with significant blows to the flank during sports activities. Copyright © 2015 Elsevier Ltd. All rights reserved.
This article was published in Injury
and referenced in Emergency Medicine: Open Access