TY - JOUR
T1 - The effect of transarterial embolization versus nephrectomy on acute kidney injury in blunt renal trauma patients
AU - Hsu, Chih Po
AU - Cheng, Chi Tung
AU - Huang, Jen Fu
AU - Fu, Chih Yuan
AU - Bajani, Francesco
AU - Bokhari, Marissa
AU - Mis, Justin
AU - Poulakidas, Stathis
AU - Bokhari, Faran
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/7
Y1 - 2022/7
N2 - Purpose: The impact of transarterial embolization (TAE) and nephrectomy on acute kidney injury (AKI) in blunt renal trauma patients remains unclear, and we used the National Trauma Data Bank (NTDB) to investigate this issue. Methods: Adult patients from the NTDB between 2007 and 2015 who survived traumatic events with blunt injuries were eligible for inclusion. The exclusion criteria were those without outcome information, who required dialysis, or with chronic renal failure prior to the traumatic injury. Patients sustaining hepatic, splenic, or pelvic fractures or who had bilateral nephrectomy were also excluded. The patients were divided into three treatment groups, including conservative treatment, TAE, and nephrectomy. Two statistical models, logistic regression (LR) and inverse probability treatment weighting (IPTW), were used to clarify the AKI predictors. Results: The study included 10,096 patients. There were 9697 (96.0%), 202 (2.0%) and 197 (2.0%) patients in the conservative, TAE and nephrectomy groups, respectively. Nephrectomy was a statistically significant predictor of AKI in blunt renal trauma patients in the standard LR (odds ratio [OR], 4.58; 95% confidence interval [CI] 1.92–10.38; p < 0.001) and IPTW (OR, 5.16; 95% CI 1.07–24.85; p = 0.023) models. In addition, TAE was not a risk factor for AKI in blunt renal trauma patients (p > 0.05 in all models). Conclusion: AKI is less likely affect patients with blunt renal trauma with TAE than those with nephrectomy. Nephrectomy is a risk factor for AKI in blunt renal trauma patients. TAE should be considered first when blunt renal trauma patients need a hemostatic procedure.
AB - Purpose: The impact of transarterial embolization (TAE) and nephrectomy on acute kidney injury (AKI) in blunt renal trauma patients remains unclear, and we used the National Trauma Data Bank (NTDB) to investigate this issue. Methods: Adult patients from the NTDB between 2007 and 2015 who survived traumatic events with blunt injuries were eligible for inclusion. The exclusion criteria were those without outcome information, who required dialysis, or with chronic renal failure prior to the traumatic injury. Patients sustaining hepatic, splenic, or pelvic fractures or who had bilateral nephrectomy were also excluded. The patients were divided into three treatment groups, including conservative treatment, TAE, and nephrectomy. Two statistical models, logistic regression (LR) and inverse probability treatment weighting (IPTW), were used to clarify the AKI predictors. Results: The study included 10,096 patients. There were 9697 (96.0%), 202 (2.0%) and 197 (2.0%) patients in the conservative, TAE and nephrectomy groups, respectively. Nephrectomy was a statistically significant predictor of AKI in blunt renal trauma patients in the standard LR (odds ratio [OR], 4.58; 95% confidence interval [CI] 1.92–10.38; p < 0.001) and IPTW (OR, 5.16; 95% CI 1.07–24.85; p = 0.023) models. In addition, TAE was not a risk factor for AKI in blunt renal trauma patients (p > 0.05 in all models). Conclusion: AKI is less likely affect patients with blunt renal trauma with TAE than those with nephrectomy. Nephrectomy is a risk factor for AKI in blunt renal trauma patients. TAE should be considered first when blunt renal trauma patients need a hemostatic procedure.
KW - Acute kidney injury
KW - Blunt renal trauma
KW - Nephrectomy
KW - Transarterial embolization
UR - http://www.scopus.com/inward/record.url?scp=85131549416&partnerID=8YFLogxK
U2 - 10.1007/s00345-022-04049-5
DO - 10.1007/s00345-022-04049-5
M3 - 文章
C2 - 35674789
AN - SCOPUS:85131549416
SN - 0724-4983
VL - 40
SP - 1859
EP - 1865
JO - World Journal of Urology
JF - World Journal of Urology
IS - 7
ER -