Khalid et al reported predictors for nephrectomy (partial or total) in a patient with high-grade renal trauma. The authors are from University Hospital Marrakech in Morocco.
Patient selection: renal trauma AAST grade III, IV or V with initial conservative treatment
Predictors of nephrectomy from multivariate analysis:
(1) perinephric hematoma > 3.5 cm
(2) higher AAST-OIS (organ injury scale) grade
(3) hypotension on admission (systolic BP < 90 mm Hg)
The risk of nephrectomy increases with the number of these predictors present.
Other factors from univariate analysis:
(1) devitalized tissue fragment > 25%
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