The morbidity of trauma nephrectomy
Norma M Edwards1, Jeffrey A Claridge, Raquel M Forsythe
1University of Tennessee Health Science Center, Department of Surgery, Memphis, TN 38163, USA.
The American Surgeon
|November 26, 2009
Summary
Patients undergoing trauma nephrectomy (TN) face high mortality and significant morbidity. Survivors frequently experience complications like renal failure and intra-abdominal abscess, highlighting the need for improved patient outcome benchmarks.
Area of Science:
- Trauma Surgery
- Nephrology
- Surgical Complications
Background:
- Trauma nephrectomy (TN) is associated with high mortality rates.
- Limited data exists on the morbidity experienced by survivors of TN.
- Understanding post-TN complications is crucial for patient management.
Purpose of the Study:
- To determine the morbidity rates in patients surviving trauma nephrectomy (TN).
- To specifically investigate the incidence of renal failure (RF) and intra-abdominal abscess (IAA) following TN.
- To establish benchmarks for assessing complication rates and improving outcomes in TN patients.
Main Methods:
- Retrospective review of trauma registry data from 1996 to 2004.
- Inclusion criteria: patients surviving at least 48 hours post-TN.
- Data collected on all complications, focusing on RF and IAA.
Main Results:
- Of 89 TN patients, 71 survived >48 hours; 51 (72%) had at least one morbidity.
- Infectious (52%), respiratory (48%), and gastrointestinal (30%) complications were common.
- Renal failure (RF) and intra-abdominal abscess (IAA) each occurred in 14% of survivors.
- Patients with morbidities were older, more severely injured, with longer hospital stays.
Conclusions:
- Trauma nephrectomy patients are severely injured and experience substantial morbidity.
- Significant complication rates, including RF and IAA, necessitate focused management strategies.
- Establishing outcome benchmarks can guide clinical practice and improve patient prognoses.
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