Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

Nakao, Shunichiro; Katayama, Yusuke; Hirayama, Atsushi; Hirose, Tomoya; Ishida, Kenichiro; Umemura, Yutaka; Tachino, Jotaro; Kiguchi, Takeyuki; Matsuyama, Tasuku; Kiyohara, Kosuke; Kitamura, Tetsuhisa; Nakagawa, Yuko; Shimazu, Takeshi

doi:https://doi.org/10.1186/s13017-020-00329-w

Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

Nakao, Shunichiro; Katayama, Yusuke; Hirayama, Atsushi et al.

World Journal of Emergency Surgery, 2020, 15, 50

アクセス数:1,699件（2025-08-16 08:16 集計）

固定URL: https://hdl.handle.net/11094/78368

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タイトル	Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan
著者	NRID 1000080834150 1000080834150 ORCID 0000-0001-5530-806X 0000-0001-5530-806X researchmap permalink shunichironakao shunichironakao Scopus Author ID 57216959268 57216959268 著者名 Nakao, Shunichiro
	NRID 1000050747144 1000050747144 ORCID 0000-0003-2585-4259 0000-0003-2585-4259 researchmap permalink orion2013 orion2013 Scopus Author ID 56470235000 56470235000 著者名 Katayama, Yusuke
	著者名 Hirayama, Atsushi
	NRID 1000070597509 1000070597509 researchmap permalink tomoyahirose tomoyahirose Scopus Author ID 41861413300 41861413300 著者名 Hirose, Tomoya
	著者名 Ishida, Kenichiro
	NRID 1000020743561 1000020743561 著者名 Umemura, Yutaka
	NRID 1000050747152 1000050747152 ORCID 0000-0002-0423-7713 0000-0002-0423-7713 researchmap permalink jotarotachino jotarotachino Scopus Author ID 57203882578 57203882578 著者名 Tachino, Jotaro
	NRID 1000030724380 1000030724380 著者名 Kiguchi, Takeyuki
	NRID 1000050829025 1000050829025 著者名 Matsuyama, Tasuku
	NRID 1000080581834 1000080581834 著者名 Kiyohara, Kosuke
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 著者名 Kitamura, Tetsuhisa
	NRID 1000040362719 1000040362719 著者名 Nakagawa, Yuko
	NRID 1000050196474 1000050196474 著者名 Shimazu, Takeshi
キーワード等	Blunt injury
	Japan Trauma Data Bank
	Nephrectomy
	Renal trauma
内容	Nakao, S., Katayama, Y., Hirayama, A. et al. Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan. World J Emerg Surg 15, 50 (2020). https://doi.org/10.1186/s13017-020-00329-w
抄録	Background: There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods: We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results: We identified 3550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8%, and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: Age ≥ 65 years (adjusted OR 3.36); pedestrian accident (adjusted OR 1.94); fall from height (adjusted OR 1.91); shock on arrival (adjusted OR 4.02); concomitant injuries to the head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90); AAST grades III-V (adjusted ORs 1.42, 2.16, and 5.55); and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: Shock on arrival (adjusted OR 1.98), concomitant injuries to the thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grades III, IV, and V (adjusted ORs 18.40, 113.89, and 468.17), and emergency abdominal angiography (adjusted OR 0.28). Conclusions: We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population.
出版者	BioMed Central Ltd
収録物名	World Journal of Emergency Surgery
巻(号)	15
ページ	50
刊行年月	2020-08-26
言語	英語
ハンドルURL	https://hdl.handle.net/11094/78368
eISSN	17497922
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1186/s13017-020-00329-w
関連情報 (isIdenticalTo)	PMID 32847621
アクセス権	open access
権利情報	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	World Journal of Emergency Surgery. 2020, 15, p. 50
DC.title	Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan
DC.creator	Nakao, Shunichiro
	Katayama, Yusuke
	Hirayama, Atsushi
	Hirose, Tomoya
	Ishida, Kenichiro
	Umemura, Yutaka
	Tachino, Jotaro
	Kiguchi, Takeyuki
	Matsuyama, Tasuku
	Kiyohara, Kosuke
	Kitamura, Tetsuhisa
	Nakagawa, Yuko
	Shimazu, Takeshi
DC.publisher	BioMed Central Ltd
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-08-26
DC.identifier	https://doi.org/10.1186/s13017-020-00329-w
DC.subject	Blunt injury
	Japan Trauma Data Bank
	Nephrectomy
	Renal trauma
DC.description	Nakao, S., Katayama, Y., Hirayama, A. et al. Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan. World J Emerg Surg 15, 50 (2020). https://doi.org/10.1186/s13017-020-00329-w
DCTERMS.abstract	Background: There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods: We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results: We identified 3550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8%, and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: Age ≥ 65 years (adjusted OR 3.36); pedestrian accident (adjusted OR 1.94); fall from height (adjusted OR 1.91); shock on arrival (adjusted OR 4.02); concomitant injuries to the head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90); AAST grades III-V (adjusted ORs 1.42, 2.16, and 5.55); and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: Shock on arrival (adjusted OR 1.98), concomitant injuries to the thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grades III, IV, and V (adjusted ORs 18.40, 113.89, and 468.17), and emergency abdominal angiography (adjusted OR 0.28). Conclusions: We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population.
DC.rights	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	78368
citation_title	Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan
citation_author	Nakao, Shunichiro
	Katayama, Yusuke
	Hirayama, Atsushi
	Hirose, Tomoya
	Ishida, Kenichiro
	Umemura, Yutaka
	Tachino, Jotaro
	Kiguchi, Takeyuki
	Matsuyama, Tasuku
	Kiyohara, Kosuke
	Kitamura, Tetsuhisa
	Nakagawa, Yuko
	Shimazu, Takeshi
citation_publisher	BioMed Central Ltd
citation_language	英語
citation_date	2020-08-26
citation_journal_title	World Journal of Emergency Surgery
citation_volume	15
citation_firstpage	50
citation_doi	https://doi.org/10.1186/s13017-020-00329-w
citation_pmid	32847621
citation_public_url	https://hdl.handle.net/11094/78368

Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

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