Journal of Medical – Clinical Research & Reviews

Abstract

Management of Kidney Trauma in Saiful Anwar General Hospital Malang Indonesia

Besut Daryanto, I Made Udiyana Indradiputra, I Gusti Lanang Andi Suharibawa.

Aims and Objectives: Kidney is the most commonly injured genitourinary organ. This study was performed to describe and analyze the characteristics of hospitalized kidney trauma patients in Saiful Anwar General Hospital Malang, Indonesia.

Materials and Method: From January 2005 to December 2016, 63 data of kidney trauma patients in Saiful Anwar general hospital were retrospectively collected. They were described and analyzed based on demographic characteristic, chief complaint, mechanism of injury, hemodynamic stability state, grade of trauma, location of trauma and management. The associations of hemodynamic state, type of management, anemic condition, grade of kidney trauma to patient’s outcome were analyzed using statistical software (SPSS). 

Results: Kidney trauma occurred mostly in male patients (47/74.6%). Pediatric involves in (22/34.9%) of total patients. Motor vehicle injury was the most common mechanism of injury (49/77.8%). Most of the patients came with flank pain as a chief complain (42/66.7%). Trauma were occurred mostly due to blunt trauma (61/96.8%), more frequent cases involved right kidney (33/52.4%). Grade I kidney trauma occurred in (40/63.5%), grade II in (10/15.9%), grade III in (9/14.3%) cases, grade IV in (1/1.6%) cases and grade V in (3/4.8%) cases. Patients who came to the emergency department mostly in stable hemodynamic state (50/79.4%). Kidney trauma patients were mostly treated with non-operative management (60/95.2%) and no significant difference of length of hospitalization was noted between conservative and operative treatment (p=0.625). It was also found that there was significant association between hemodynamic state and treatment options (p=0.047). However, no association was noted between the type of management and patients’ outcome (p=0.436). Severe grade of trauma revealed increasing nephrectomy rate (OR: 174, 95% CI: 8.62-315.174; p<0.01).

Conclusion: Most of kidney trauma patients in Saiful Anwar Hospital were uneventfully treated by conservative treatment. Severe grade of trauma increased the risk of nephrectomy.

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