Renal trauma: a 3‐year audit from a Gold Coast trauma centre

Renal trauma trends from a Gold Coast trauma centre, including mechanisms of injury, American Association for the Surgery of Trauma (AAST) grades of injury, associated injuries, management and complications. Unique mechanisms in the authors' institution included Australian Rules Football‐ and Surf‐related renal trauma. Outcomes supported that the majority of haemodynamically stable high‐grade renal trauma can be successfully managed conservatively.

Background

Limited data Exists ? on the Australian epidemiology of renal trauma, with very few studies published in the literature. The authors aim to detail the trends of renal trauma in the coastal city of the Gold Coast.

Methods

Retrospective data collection yielded 81 patients who sustained renal trauma from our 3‐year period. Data included information on demographics, mechanism, American Association for the Surgery of Trauma (AAST) grade, presence of haematuria, associated injuries, management, and complications.

Results

Male patients accounted for 83% (n = 67) of cases, and the average age of all injuries was 36 years. Low‐grade AAST Grade I–III injuries comprised of 76% (n = 62) of injuries, AAST Grade IV contributed to 20% (n = 16) and 4% (n = 3) of injuries were AAST Grade V. The most common mechanism of injury was road accidents accounting for 35% (n = 28) followed by fall‐related injuries (26%, n = 21). Other mechanisms included sport‐related (13.5%, n = 11), non‐motorized bicycle injuries (8.5%, n = 7), alleged assault (8.5%, n = 7), pedestrian injuries (5%, n = 4) and horse‐related injuries (2%, n = 2). Ninety‐six percent (n = 78) of kidney injuries were managed conservatively. Of the patients requiring intervention, all were AAST Grade V kidney injuries.

Conclusion

Males accounted for the majority of renal trauma cases, similar to the 3:1 ratio of male‐to‐female injuries found in other studies. In line with other studies, renal trauma reviewed on the Gold Coast also revealed road trauma as the leading cause, closely followed by falls. The majority of high‐grade renal trauma was managed conservatively.

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