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Nomogram of Shariat et al for Predicting Exploration in a Patient with Renal Trauma

Purpose: To identify a patient with renal trauma who may require surgical exploration based on the nomogram of Shariat et al.

Description

Shariat et al developed a nomogram for identifying a patient with renal trauma who will undergo surgical exploration. This can help to distinguish a patient who can be managed conservatively from a patient who may benefit from more aggressive management. The authors are from University of Texas Southwestern Medical Center, University of Montreal and Brooke Army Medical Center.


Parameters:

(1) trauma type

(2) need for blood transfusion

(3) BUN

(4) creatinine

(5) Grade of renal injury

 

Parameter

Finding

Points

trauma type

blunt trauma

0

 

stab wound

31

 

gunshot

58

transfusion

no

0

 

yes

32

BUN

> 12 mg/dL

0

 

6 to 12 mg/dL

27

 

< 6 mg/dL

35

serum creatinine

<= 1.3 mg/dL

0

 

> 1.3 mg/dL

28

grade of renal trauma

grade 1

0

 

grade 2

25

 

grade 3

50

 

grade 4

75

 

grade 5

100

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 253

• The higher the score the greater the chances of being explored.

 

Total Score

Percent Explored

< 49

<= 0.1%

49 to 77

<= 1%

78 to 90

1 to 3%

90 to 150

(0.01626 * ((points)^2)) - (2.598 * (points)) + 103.6

150 to 173

(-0.01569 * ((points)^2)) + (5.834 * (points)) - 442.9

173 to 190

96-99%

> 190

> 99%

 


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Specialty

Objective

ICD-10