Major predictors for the need of nephrectomy:
(1) Grade 4 or 5 renal trauma (50% and 88 % respectively)
(2) gunshot wound or other penetrating injury
Additional predictors for the need of nephrectomy:
(3) hemodynamic instability
(4) overall injury severity (ISS >= 16)
(5) ongoing transfusion requirement
(6) Glasgow coma scale <= 10
where:
• The odds ratios for the grade of renal trauma and penetrating injury from multivariate analysis are reported (both in the order of 20).
• The odds ratios for the other factors are not given although reported as being significant. The cutoffs for the additional predictors are not stated; the values are taken from Table 2, page 166.
Findings usually not associated with a need for nephrectomy:
(1) Grade 1 to 3 renal trauma
If the patient is hemodynamically stable, then a helical CT scan is the preferred imaging study to evaluate a patient with hematuria.
