Introduction

Renal trauma is the most frequent genitourinary trauma. Current guidelines recommend bed-rest in patients with renal trauma. However, there is no data in the literature to support this recommendation. The aim of this study was to assess the impact of early vs. delayed mobilization on the outcomes of renal trauma management.

Methods

A retrospective multicenter study was conducted including all patients treated for renal trauma in 17 hospitals between 2005 et 2015. Iatrogenic trauma were excluded. Patients were divided in two groups : early mobilization (within the first 24 hours after admission, EM) and delayed mobilization (> 24 hours after admission, DM). The choice of the day of mobilization was made on an individual basis, according to local protocols and was not standardized. Patients’ characteristics and outcomes were compared between the two groups

Results

_x000D_ Out of 1799 patients, data regarding the day of mobilization was found in the medical records of 918 patients : 153 in the EM group and 765 in the DM group. There was less grade 4 of 5 trauma in the EM group (11.4% vs. 32.3%; p<0.0001), less concomittant solid organ injuries (19.1% vs. 49.7% ;p<0.0001) and less concomittant bone injuries (18.7% vs. 45.8%;p=0.0001). The rates of transfusion and of surgery/interventional radiology after mobilization were similar in both groups (2% vs. 2.4% ;p=0.99 and 2.7% vs. 4.1% ;p=0.49 respectively). In contrast, interval between admission and return of bowel function was shorter in the EM group (0.7 vs. 4 days ;p<0.0001) as was lenght of hospital stay (4.1 vs. 14.8 days ; p<0.0001)_x000D_ In multivariate analysis, EM was not associated with the risk of surgery/interventional radiology nor with transfusion after mobilization (OR=0.86 ; p=0.82 et OR=1.1 ; p=0.87 respectively). In contrast, EM remained associated with shorter time to return of bowel function (?=0.35 ; p<0.0001) and shorter length of stay (?=0.17 ; p<0.0001)._x000D_

Conclusions

In this multicenter study, early mobilization after renal trauma did not increase the risk of secondary transfusion nor secondary surgery/interventional radiology an was associated with shorter time to return of bowel function and length of stay.

Funding

none