For a study, researchers sought to determine if routine repeat imaging was linked to urologic intervention or complications in children with nonoperatively managed renal damage. Using 2005 to 2019, 337 pediatric patients with blunt and penetrating renal trauma (RTP) were retrospectively evaluated from a prospectively collected database at a Level I trauma hospital. Age more than 18 years old, mortality during admission (N=39), urgent operational intervention (N=28), and low-grade renal damage (AAST grades I-II, N=91) were all exclusion criteria. Reimaging in asymptomatic individuals within 72 hours of acute damage was considered routine repeat imaging. Patients were divided into 3 imaging groups: those who had standard repeat imaging, those who had symptoms reimaged, and those who had no symptoms reimaged. The comparisons were made using logistic regression, which considered the severity of the renal damage. Of the 179 children who were involved in the study, 44 (25%) had regular repeat imaging, 20 (11%) had symptoms reimaged, and 115 (64%) were handled without reimaging. Asymptomatic patients in the joint repeat imaging group and without reimaging group were significantly less likely to develop a complication (16% and 7% vs 55%, p=0.001) or require a delayed urologic procedure (5% and 1% vs 25%, P=0.007) than patients who were reimaged for symptoms. Investigators found no difference in complications (p=0.47), readmissions (p=0.75), or urologic treatments (p=0.50) between those who had routine repeat imaging and those who did not. Despite having high-grade (III-IV) renal damage, most pediatric patients who remained asymptomatic for the first 3 days of their hospital stay did not require urologic intervention. In the absence of signs or symptoms of concern, skipping repeat imaging was not related to a greater likelihood of problems or delayed operations, implying that frequent repeat imaging might expose these children to unnecessary radiation and might even be preventable.
Source:www.sciencedirect.com/science/article/abs/pii/S1477513121005283
