Epidemiological analysis of polytrauma patients with kidney injuries in a university hospital

Objective: To analyze the characteristics of trauma patients with renal lesions treated at a university hospital in Curitiba. Methods: We conducted a retrospective, cross-sectional study guided by review of medical records of trauma victims who underwent surgical treatment. The variables analyzed were age, gender, mechanism of injury, degree of kidney damage, conduct individualized according to the degree of renal injury, associated injuries, complications and deaths. We classified lesions according to the American Association of Trauma Surgery (TSAA). Results: We analyzed 794 records and found renal lesions in 33 patients, with mean age 29.8 years, most (87.8%) being male. Penetrating trauma accounted for 84.8% of cases. The most common renal injuries were grade II (33.3%), followed by grade I (18.1%), III, IV and V. Nephrectomy treated 45.4% of injuries, 73.3% being total nephrectomy, and 45.4% by nephrorraphy. In 9% treatment was non-surgical. Only 12.1% of patients had isolated renal lesions. Complications ensued in 15.1% and mortality was 6.06%. Conclusion: The surgical approach was preferred due to penetrating trauma mechanism. We achieved low rates of complications and deaths, and neither case could be directly related to kidney damage, and there were patients with multiple lesions. In this sample, we could not observe a direct relationship between kidney damage and complications, deaths or the type of conduct employed.

研究目的：旨在分析巴西库里蒂巴某大学医院收治的肾损伤创伤患者的临床特征。
研究方法：本研究为回顾性横断面研究，通过回顾接受手术治疗的创伤患者的病历资料开展研究。本次分析的变量包括患者年龄、性别、损伤机制、肾损伤分级、基于肾损伤分级制定的个体化诊疗方案、合并损伤、并发症及死亡情况。本研究参照美国创伤外科协会（American Association of Trauma Surgery, TSAA）标准对肾损伤进行分级。
研究结果：本研究共纳入794份病历，其中33例患者合并肾损伤，患者平均年龄为29.8岁，男性占比达87.8%。穿透性创伤占所有病例的84.8%。最常见的肾损伤分级为Ⅱ级（33.3%），其次为Ⅰ级（18.1%）、Ⅲ级、Ⅳ级及Ⅴ级。45.4%的肾损伤患者接受了肾切除术，其中73.3%为全肾切除术，45.4%接受肾修补术，另有9%的患者采用非手术治疗方案。仅12.1%的患者为单纯肾损伤。并发症发生率为15.1%，总体病死率为6.06%。
研究结论：鉴于本研究样本中创伤以穿透性损伤为主，手术治疗为首选干预方式。本研究的并发症与病死率均处于较低水平，且无死亡病例直接与肾损伤相关；同时样本中存在多发合并损伤的患者。在本次研究队列中，未观察到肾损伤程度与并发症发生率、病死率或诊疗方案类型之间存在直接关联。