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

Number of Access:1,798（2025-10-22 07:50 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/78368

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Title	Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan
Creator	NRID 1000080834150 1000080834150 ORCID 0000-0001-5530-806X 0000-0001-5530-806X researchmap permalink shunichironakao shunichironakao Scopus Author ID 57216959268 57216959268 CreatorName Nakao, Shunichiro
	NRID 1000050747144 1000050747144 ORCID 0000-0003-2585-4259 0000-0003-2585-4259 researchmap permalink orion2013 orion2013 Scopus Author ID 56470235000 56470235000 CreatorName Katayama, Yusuke
	CreatorName Hirayama, Atsushi
	NRID 1000070597509 1000070597509 researchmap permalink tomoyahirose tomoyahirose Scopus Author ID 41861413300 41861413300 CreatorName Hirose, Tomoya
	CreatorName Ishida, Kenichiro
	NRID 1000020743561 1000020743561 CreatorName Umemura, Yutaka
	NRID 1000050747152 1000050747152 ORCID 0000-0002-0423-7713 0000-0002-0423-7713 researchmap permalink jotarotachino jotarotachino Scopus Author ID 57203882578 57203882578 CreatorName Tachino, Jotaro
	NRID 1000030724380 1000030724380 CreatorName Kiguchi, Takeyuki
	NRID 1000050829025 1000050829025 CreatorName Matsuyama, Tasuku
	NRID 1000080581834 1000080581834 CreatorName 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 CreatorName Kitamura, Tetsuhisa
	NRID 1000040362719 1000040362719 CreatorName Nakagawa, Yuko
	NRID 1000050196474 1000050196474 CreatorName Shimazu, Takeshi
Subject	Blunt injury
	Japan Trauma Data Bank
	Nephrectomy
	Renal trauma
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
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.
Publisher	BioMed Central Ltd
Source Title	World Journal of Emergency Surgery
Volume (Issue)	15
Page	50
Date of Issued	2020-08-26
Language	English
Handle URL	https://hdl.handle.net/11094/78368
eISSN	17497922
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/s13017-020-00329-w
Relation.isIdenticalTo	PMID 32847621
Access Rights	open access
CopyRight	© 2020 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	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	English
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	English
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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