Sports-related trauma and its impact on isolated high-grade renal injury
Blunt force sports-related trauma often produces isolated high-grade renal injury, according to a new study at the 109th Annual Scientific Meeting of the American Urological Association (AUA).
The kidney is the third most common organ, after the spleen and liver, to sustain damage as a result of blunt force trauma. High-grade renal injury [Grade III-V as defined by the American Association for the Surgery of Trauma (AAST)] is often seen concurrent with other injuries resulting from motor vehicle collisions; however in many cases, high-grade renal injury also can occur independently as a sports- related injury. When renal injury occurs from these activities, it is primarily due to a single blow to the abdomen or side.
To determine if sports-related trauma is capable of directly producing high-grade kidney injury, researchers from the University of Utah and Intermountain Medical Center conducted a statewide study using information gathered from the state trauma database. Researchers reviewed the records of renal trauma patients treated at Utah-based trauma centers between January 2005 and January 2011. Data on patient demographics, injury characteristics, management, and outcomes was collected and available radiological imaging was reviewed. Renal injury was graded using the AAST organ injury severity scale.
- Thirty percent of injuries to a kidney were sustained during sporting activities, with more men experiencing an injury than women.
- Cycling, skiing and snowboarding accounted for the majority of isolated high-grade sports- related renal injuries.
- The mean injury severity score for sports-related trauma was 12.6 and for non-sports related trauma was 27.3.
- The mean AAST renal trauma grade was 3.5 (SD 0.55) for sport-related injury and 3.7 (SD 0.78) for non-sport-related injury.
Researchers concluded, treating clinicians should be made aware that sports-related renal trauma can occur in isolation and is not only associated with multiple traumatic injuries.
"While it is common to suspect renal injury following a car accident, this type of injury isn't always obvious in patients with sports-related trauma," said Dr. McAninch. "This study clearly shows that high-grade renal trauma can result if an individual receives a solitary blow to their abdomen or side when taking part in sports-related activities such as skiing, snowboarding or cycling - treating physicians should be mindful to consider this possibility when examining patients with sports-related injuries."