Introduction: Major trauma care in Ireland is managed through a multidisciplinary collaborative approach between trauma surgeons and organ subspecialists e.g. urologists, cardiothoracic surgeons, neurosurgeons etc. Thus the urology service directs the management of all urological trauma irrespective of the grade of injury or other organ involvement. This is in contrast to the management of trauma care in other jurisdictions such as the United States where the majority of trauma cases are primarily managed by trauma surgeons with other specialities consulted as required. One recent study found that urology was consulted in only 15% of high grade renal trauma cases presenting to their institution even though urology consultation was associated with a lower nephrectomy rate (36.4% vs 78.8%).1 We hypothesised that the standardised urology directed care of renal injuries in Ireland would be associated with comparatively higher rates of renal preservation and reduced intervention/nephrectomy. The aim of our study was to evaluate the management of high grade renal trauma in Ireland using data derived from the Irish Major Trauma Audit which is stored on the Trauma Audit and Research Network (TARN) database. Methods: The TARN database was used to identify all cases of significant renal trauma presenting to the 26 trauma receiving hospitals in Ireland between 2014 and 2020. Demographic data, mechanism of injury, injury characteristics, management and patient outcomes were analysed. Results: There were a total of 426 renal trauma cases recorded during the study period, of which 305 patients had a high grade renal injury. The majority of patients in this group were male (241 (79%)). The median age was 28 years (range: 0.3-93.9 years). There were 276 cases of blunt renal trauma (90%) and 29 cases of penetrating trauma (10%). The most common cause for blunt renal trauma was road traffic accident. 65 patients (21%) required blood or blood products. Seven patients underwent emergency nephrectomy or renorraphy (2%). Conclusions: The need for emergency nephrectomy due to high grade renal trauma in Ireland is exceedingly rare. We conclude that an integrated multidisciplinary approach to trauma care results in a higher likelihood of avoiding intervention in this cohort of patients. 1 Wang SL, Agrawal P, Rostom M, Gupta N, et al. Urology Consult: Association with Renal Trauma Imaging and Intervention. Urology 2022 (In press) SOURCE OF Funding: None
