https://doi.org/10.4081/aiua.2025.13939
Analysis of factors associated with length of stay in renal trauma patients: a single-centre retrospective study
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 23 June 2025
Background: Renal trauma represents a critical injury requiring precise management with the length of hospital stay (LOS) serving as a key metric for trauma care. Recognizing the factors contributing to extended LOS is essential for optimizing treatment strategies and enhancing patient outcomes. This study aims to analyse the risk factors influencing LOS in patients with renal trauma.
Methods: This retrospective cohort study was conducted at Dr. Saiful Anwar General Hospital, Malang, analysing medical record data of renal trauma patients from 2013 to 2023. Collected variables included demographics, mechanism of injury, associated injuries, hemodynamic status upon admission, injury severity, haemoglobin levels, LOS, management approach, and mortality outcomes. Univariate and multivariate analyses were performed to assess the impact of each variable on LOS.
Results: 119 renal trauma patients were included. The average age was 40.1 ± 16.86 years, and 77.3% of the participants were male. The average LOS was 6.85 ± 3.85 days. Blunt renal trauma was the predominant mechanism, accounting for 95.8% of cases, while associated injuries were observed in 53.1% of patients. Upon hospital admission, 66.4% of cases presented with stable hemodynamic status, and non-operative management was employed in 92.4% of cases. Prolonged LOS was significantly associated with age, blunt trauma, associated injuries, hemodynamic instability, and low haemoglobin levels in both univariate and multivariate analyses.
Conclusions: Age, mechanism of injury, associated injuries, hemodynamic status at admission, and haemoglobin levels significantly impact LOS in renal trauma patients. Identifying these factors may aid in improving patient management and reducing hospitalization duration.
Downloads
Baghdanian AH, Baghdanian AA, Armetta A, et al. Utility of MDCT findings in predicting patient management outcomes in renal trauma. Emerg Radiol. 2017; 24:263-72. DOI: https://doi.org/10.1007/s10140-016-1473-3
Mingoli A, La Torre M, Migliori E, et al. Operative and nonoperative management for renal trauma: comparison of outcomes. A systematic review and meta-analysis. Ther Clin Risk Manag. 2017;13:1127-38. DOI: https://doi.org/10.2147/TCRM.S139194
Zabkowski T, Skiba R, Saracyn M, Zielinski H. Analysis of renal trauma in adult patients: a 6-year own experiences of trauma center. Urol J. 2015; 12:2276-9.
McPhee M, Arumainayagam N, Clark M. Renal injury management in an urban trauma centre and implications for urological training. Ann R Coll Surg Engl. 2015; 97:194-7. DOI: https://doi.org/10.1308/003588414X14055925061117
Voelzke BB, Leddy L. The epidemiology of renal trauma. Transl Androl Urol. 2014; 3:143-9.
Hampson LA, Radadia KD, Odisho AY, et al. Conservative management of high-grade renal trauma does not lead to prolonged hospital stay. Urology. 2018; 115:92-5. DOI: https://doi.org/10.1016/j.urology.2017.11.018
Al-Qudah HS, Santucci RA. Complications of Renal Trauma. Urol Clin North Am. 2006;33:41-53. DOI: https://doi.org/10.1016/j.ucl.2005.10.005
Santucci RA, Wessells H, Bartsch G, et al. Evaluation and management of renal injuries: consensus statement of the renal trauma subcommittee. BJU Int. 2004; 93:937-54. DOI: https://doi.org/10.1111/j.1464-4096.2004.04820.x
Davis P, Bultitude MF, Koukounaras J, et al. Assessing the usefulness of delayed imaging in routine followup for renal trauma. J Urol. 2010; 184:973-7. DOI: https://doi.org/10.1016/j.juro.2010.04.070
McCombie SP, Thyer I, Corcoran NM, et al. The conservative management of renal trauma: a literature review and practical clinical guideline from Australia and New Zealand. BJU Int. 2014;114:13-21. DOI: https://doi.org/10.1111/bju.12902
McGuire J, Bultitude MF, Davis P, et al. Predictors of outcome for blunt high grade renal injury treated with conservative intent. J Urol. 2011; 185:187-91. DOI: https://doi.org/10.1016/j.juro.2010.08.085
Shoobridge JJ, Bultitude MF, Koukounaras J, et al. A 9-year experience of renal injury at an A ustralian level 1 trauma centre. BJU Int. 2013; 112:53-60.
Fitzgerald CL, Tran P, Burnell J, et al. Instituting a conservative management protocol for pediatric blunt renal trauma: evaluation of a prospectively maintained patient registry. J Urol. 2011;185:1058-64. DOI: https://doi.org/10.1016/j.juro.2010.10.045
Aguayo P, Fraser JD, Sharp S, et al. Nonoperative management of blunt renal injury: a need for further study. J Pediatr Surg. 2010;45:1311-4. DOI: https://doi.org/10.1016/j.jpedsurg.2010.02.109
Biffl WL, Lu N, Schultz PR, et al. Improving length of stay on a trauma service. Trauma Surg Acute Care Open. 2021; 6:e000744. DOI: https://doi.org/10.1136/tsaco-2021-000744
Kashkooe A, Yadollahi M, Pazhuheian F. What factors affect length of hospital stay among trauma patients? A single-center study, Southwestern Iran. Chin J Traumatol. 2020; 23:176-80. DOI: https://doi.org/10.1016/j.cjtee.2020.01.002
St. Peter SD, Sharp SW, Snyder CL, et al. Prospective validation of an abbreviated bedrest protocol in the management of blunt spleen and liver injury in children. J Pediatr Surg. 2011;46:173-7. DOI: https://doi.org/10.1016/j.jpedsurg.2010.09.079
Salem MS, Urry RJ, Kong VY, et al. Traumatic renal injury: Five-year experience at a major trauma centre in South Africa. Injury. 2020; 51:39-44. DOI: https://doi.org/10.1016/j.injury.2019.10.034
Petrone P, Perez-Calvo J, Brathwaite CEM, et al. Traumatic kidney injuries: A systematic review and meta-analysis. Int J Surg. 2020; 74:13-21. DOI: https://doi.org/10.1016/j.ijsu.2019.12.013
Nakao S, Katayama Y, Hirayama A, et al. Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan. World J Emerg Surg 2020;15:50. DOI: https://doi.org/10.1186/s13017-020-00329-w
Khairani AF, Azka AN, Faried A, et al. Characteristic of motor vehicle accident patients presenting to a national referral hospital in West Java, Indonesia. Southeast Asian J Trop Med Public Health 2018; 49:887-93.
Haghparast-Bidgoli H, Saadat S, Bogg L, et al. Factors affecting hospital length of stay and hospital charges associated with road traffic-related injuries in Iran. BMC Health Serv Res. 2013; 13:281. DOI: https://doi.org/10.1186/1472-6963-13-281
Bjurlin MA, Fantus RJ, Fantus RJ, Villines D. Comparison of nonoperative and surgical management of renal trauma: Can we predict when nonoperative management fails? J Trauma Acute Care Surg. 2017; 82:356-61. DOI: https://doi.org/10.1097/TA.0000000000001316
Cimbanassi S, Chiara O, Leppaniemi A, et al. Nonoperative management of abdominal solid-organ injuries following blunt trauma in adults: Results from an International Consensus Conference. J Trauma Acute Care Surg. 2018; 84:517-31. DOI: https://doi.org/10.1097/TA.0000000000001774
Duarsa GWDP, Satyagraha P, Daryanto B. Non-operative management for high-grade isolated renal trauma in pediatric patients: a case series. Pan Afr Med J. 2023; 44:71. DOI: https://doi.org/10.11604/pamj.2023.44.71.36833
McAninch JW, Carroll PR, Klosterman PW, et al. Renal reconstruction after injury. J Urol. 1991; 145:932-7. DOI: https://doi.org/10.1016/S0022-5347(17)38494-X
Lingsma HF, Bottle A, Middleton S, et al. Evaluation of hospital outcomes: the relation between length-of-stay, readmission, and mortality in a large international administrative database. BMC Health Serv Res. 2018; 18:116. DOI: https://doi.org/10.1186/s12913-018-2916-1
Shoobridge JJ, Bultitude MF, Koukounaras J, et al. A 9-year experience of renal injury at an Australian level 1 trauma centre. BJU Int. 2013;112:S53-60. DOI: https://doi.org/10.1111/bju.12003
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.