Up and moving: safety of early ambulation after minor renal trauma

To evaluate the safety and clinical outcomes of early ambulation versus traditional bedrest in stable adults with low-grade renal trauma.

This retrospective cohort study included adult patients (≥ 18 years) with AAST Grade 1-3 renal injuries and ISS < 15 admitted at a single institution between January 2020 and December 2024. Before November 2023, protocol was bedrest until stable hematocrit for 24 h prior to initiating ambulation, followed by repeat hematocrit to ensure stability. After institutional change, eligible participants were not placed on bedrest and allowed to ambulate immediately. Patients were grouped into the bedrest cohort (pre-protocol change) and early ambulation cohort (post-change). Demographic and clinical data were collected. Primary outcome was need for transfusion or procedure during admission. Secondary outcomes included LOS, DVT, future ED visits, readmissions, and interventions.

Sixty patients met inclusion criteria (48 bedrest; 12 early ambulation). There were no significant differences in median age, sex, injury grade, ISS. Transfusion or procedural requirements were not significantly different. Two patients (4.2%) in the bedrest cohort returned to the ED for flank pain, while none in the early ambulation cohort had a subsequent ED presentation (p = 1.0). No patients required readmission for hemorrhage or procedural intervention. Median LOS was 4 days for the bedrest group and 3 days for the early ambulation group (p = 0.27).

Early ambulation following low-grade renal trauma appears safe and is not associated with increased complications or interventions. These findings support reconsidering bedrest protocols and suggest early mobilization may improve hospital efficiency.