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Northern New England Renal Trauma: How It Differs From The Big City
Elizabeth B Johnson, Levi A Deters, Paul A Merguerian
Dartmouth Hitchcock Medical Center, Lebanon, NH

Renal injury occurs in up to 10% of blunt force injuries. Rural populations have a higher rate of trauma and are 50% more likely to suffer a trauma related death than their urban counterparts. We reviewed the mechanism of injury, management and outcomes of patient admitted with renal injury at a single rural level 1 trauma center . We hypothesize that the mechanisms of injury and the outcomes are different than in published urban data.

Materials & Methods:
After institutional review board approval we retrospectively reviewed the charts of all adult patients (>19 years of age) admitted from 2006-2010 with renal trauma. Variables evaluated included age, gender, intoxication status, grade, mechanism of injury, and associated abdominal injuries. Management and outcomes were analyzed.

Of the 104 patients admitted 80 (77%) were male and 24 (23%) female. Mean age was 44 years. Blunt force trauma accounted for the majority of injuries (98%). The most common mechanism of injury was motor vehicle collision(MVC) 36/104(35%), followed by recreation related activities 35/104 (34%), falls (16%), and motor cycle crash 17/104(16%). Winter related activities accounted for 19/24 (79%) of recreational injuries. Five patients (6%) required embolization and one required emergent nephrectomy. Mortality was 8/104(8%). MVC resulted in significantly more multiple intra-abdominal injuries (64% vs 29%, p=0.0173).


Unlike urban setting, our data from a rural center shows that recreational renal injuries were as common as MVCs. MVCs were found to result in significantly more multi organ injuries. Management of renal trauma remains mostly nonoperative.

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