Trends in Presentation and Management of Pediatric Renal Trauma

Abstract

ObjectiveWe queried the Pediatric Health Information System (PHIS) to evaluate the presentation, management, and outcomes of renal trauma in children from birth to 18 years from 2007 to 2018. MethodsPatients were categorized as infants (0-1 year), toddlers (2-4 years), children (5-9 years), preteen (10-14 years), and teens (15-18 years) and patient demographics, grade of injury, and mechanism of injury including sports related trauma were collected. Each group was then evaluated for the level of management and patient outcome. ResultsWe identified 3720 patients with renal trauma. Our cohort was predominantly white (68.5%), male (68.6%), and required public insurance (38.5%). Most injuries were low grade (86.7%) and managed non-operatively (94.7%). The overall mortality was 51 (1.4%). Younger patients (infants, toddlers, children) were more likely to present with complex injuries and they were more likely to have been involved in a motor vehicle accident. They had higher blood transfusion rates, longer inpatient courses, higher levels of admission acuity, and higher mortality. Patients in the older age groups presented most after Sport Related Trauma (SRT). Across all age groups, the most common source of SRT was limited contact sports; however, when considering only teens, full contact sports were the primary offending activity. This review of the PHIS database provides insight to the rates and patterns of pediatric renal trauma in the United States. ConclusionOur data suggests an age-related differences in the presentation, management, and outcomes of pediatric renal trauma patients.