To Evaluate the Predictors of Delayed Nephrectomy in High Grade Blunt Renal Trauma Patients Treated Primarily With Conservative Line of Management

Introduction: There is no unanimity on the optimal management of high grade renal trauma. High renal losses likely to be seen in immediate surgical intervention, while secondary hemorrhage and persistent urinary extravasation is due to delayed surgical intervention. Materials And Methods: The records of 118 patients who were admitted to our institute with varying degrees of blunt renal trauma from January 2013 to June 2023 were retrospectively reviewed. Grade III-V renal injury was dened as high grade blunt renal trauma and was present in 48 patients. The factors analyzed to predict emergency intervention were demographic prole, grade of injury, degree of hemodynamic instability, requirement of blood transfusion and duration of intensive care unit stay. Results: The 70 patients with grade I and II renal injury did not require emergency intervention and underwent a trail of conservative management. 12 of the 48 patients with high grade renal injury (grade III to V) underwent nephrectomy (9 immediate and 3 delayed) . Presence of grade V injury with hemodynamic instability and requirement of more than 10 packed cell units for resuscitation were predictors of nephrectomy. Conclusion: Majority of the high grade renal injuries can be successfully managed conservatively. Grade V injuries required immediate nephrectomy, the need for more than 10 packed cell transfusions during resuscitation predict the need for delayed nephrectomy