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Trends in Presentation and Management of Pediatric Renal Trauma
Kiersten M Craig1, M D Imaani Easthausen1, Yuqing Qiu1
1New York Presbyterian/ Weill Cornell Medical College The Institute for Pediatric Urology, New York, NY.
Insights
Pediatric renal trauma varies by age. Younger children face complex injuries and higher mortality, often from accidents, while teens sustain injuries from sports. Management and outcomes differ significantly across age groups.
Area of Science:
- Pediatric Urology
- Trauma Surgery
- Public Health
Background:
- Renal trauma in children presents unique challenges.
- Understanding age-specific patterns is crucial for effective management.
- The Pediatric Health Information System (PHIS) database offers valuable insights.
Approach:
- A retrospective analysis of 3720 pediatric renal trauma cases (2007-2018) from the PHIS database.
- Patients were stratified into five age groups: infants, toddlers, children, preteens, and teens.
- Demographics, injury characteristics, management strategies, and outcomes were evaluated for each age group.
Key Points:
- Most pediatric renal trauma cases were low-grade (86.7%) and managed non-operatively (94.7%).
- Younger children (infants to children) had higher rates of complex injuries, motor vehicle accident involvement, blood transfusions, longer hospital stays, and increased mortality.
- Older children and teens (preteens, teens) were more frequently injured through sports-related trauma (SRT), with full-contact sports being a primary cause in teens.
Conclusions:
- Significant age-related differences exist in the presentation, management, and outcomes of pediatric renal trauma.
- These findings highlight the need for age-tailored approaches in the evaluation and treatment of pediatric renal injuries.
- The study provides a comprehensive overview of pediatric renal trauma epidemiology in the United States.
Objective:
We 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 2007-2018.
Methods:
Patients 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 (SRT) were collected. Each group was then evaluated for the level of management and patient outcome.
Results:
We 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 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.
Conclusion:
Our data suggest an age-related differences in the presentation, management, and outcomes of pediatric renal trauma patients.
