Traumatic kidney injury in multiorgan trauma patients: Experience of trauma center

• Main Authors: Leszek Sulkowski, Maciej Matyja
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: MGM Journal of Medical Sciences
• Subjects: multiorgan trauma; surgery in trauma patient; trauma; traumatic kidney injury
• Online Access: http://www.mgmjms.com/article.asp?issn=2347-7946;year=2019;volume=6;issue=3;spage=118;epage=122;aulast=Sulkowski

Introduction: Traumatic kidney injury (TKI) remains a challenging element of multiorgan trauma. We present a 9-year experience of a trauma center with surgical management of multiorgan trauma patients with TKI. Materials and Methods: The inclusion criteria for this study were TKI in multiorgan trauma patients receiving surgical management. During 9 years, 10,191 patients were hospitalized to the Department of General Surgery. Forty-nine of these multiorgan trauma patients had associated TKI. Results: The severity of the kidney injury was classified on a five-point Organ Injury Scale proposed by the American Association for the Surgery of Trauma. Injuries to other organs were also evaluated. The surgical approach was either laparotomy or laparotomy with thoracotomy, depending on the severity of trauma. Discussion: Abdominal trauma may involve kidneys, especially when the injury is severe and affecting multiple organs. This may be seen in both the adult and pediatric populations. The treatment depends on the severity of organ injuries, hemodynamic stability of the patient and may be either surgical or conservative. Hemodynamically unstable patients received damage control surgery, whereas the stable ones underwent computed tomography before the decision on optimal treatment modality. The most severe vascular injuries are associated with a high mortality rate. Conclusion: TKIs usually appear in young males and predominantly follow blunt abdominal trauma. TKI is usually an element of complex multiorgan trauma with severe injuries to other organs.