Profile of renal artery embolization (RAE) for renal trauma: A comparison of data from two major trauma centers

Background: The aim of this article is to elucidate the current situation of renal interventional therapy and discuss the indications for this treatment. Methods: A retrospective study was performed evaluating the electronic medical records of all patients with renal trauma admitted to two major comprehensive hospitals in Shantou city from January 2006 to December 2015. Results: There were 264 and 304 renal traumatic patients admitted to hospital A and B, respectively. low-grade renal trauma(LGRT) was the reason for presentation in the majority of patients (522, 91.9%). A total of 534 (94.0%) patients were treated conservatively. RAE was performed in 9 patients from 2012 to 2015 at hospital A, including in 6 patients (6/9, 66.7%) with LGRT, and 3 patients (3/9, 33.3%) with high-grade renal trauma (HGRT). No patient underwent interventional therapy (RAE) at hospital B during the same period. No significant differences in the operative rate of hospital A were observed between the two time periods (2006-2011 and 2012-2015). The operative rate for LGRT between the two hospitals from 2006 to 2011 and 2012 to 2015 was not significantly different. Hospital A showed a significant decrease in the rate of conservative treatment for patients with LGRT. In the univariate analyses, the American Association for the Surgery of Trauma (AAST) renal grade was significantly associated with undergoing RAE. Additionally, in the multivariate analysis, only the AAST renal grade (odds ratio [OR], 13.56; 95% confidence interval [CI], 2.91-63.06) was significantly associated with undergoing RAE. Conclusions: LGRT was present in the majority of patients, and most cases of renal trauma could be treated with conservative treatment. RAE was well utilized for the treatment of renal trauma. However, some patients with LGRT were treated with unnecessary interventional therapy.