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Journal Articles World Journal of Urology Year : 2020

Early discharge in selected patients with low-grade renal trauma

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Lucas Freton
  • Function : Correspondent author
  • PersonId : 1067158

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Clémentine Millet
  • Function : Author
Sébastien Bergerat
  • Function : Author
Paul Panayatopoulos
  • Function : Author
Reem Betari
  • Function : Author
Xavier Matillon
  • Function : Author
Ala Chebbi
  • Function : Author
Thomas Caes
  • Function : Author
Pierre-Marie Patard
  • Function : Author
Nicolas Szabla
  • Function : Author
Nicolas Brichart
  • Function : Author
Axelle Boehm
  • Function : Author
Laura Sabourin
  • Function : Author
Kerem Guleryuz
  • Function : Author
Charles Dariane
Cédric Lebacle
  • Function : Author
Jérome Rizk
  • Function : Author
Alexandre Gryn
  • Function : Author
François-Xavier Madec
  • Function : Author
François-Xavier Nouhaud
  • Function : Author
Xavier Rod
  • Function : Author
Gaelle Fiard
  • Function : Author
Benjamin Pradere
  • Function : Author
Benoit Peyronnet

Abstract

Introduction: the aim of this study was to assess whether early discharge could be non-inferior to inpatient management in selected patients with low-grade renal trauma (AAST grades 1–3).Materials and methods: A retrospective national multicenter study was conducted including all patients who presented with renal trauma at 17 hospitals between 2005 and 2015. Exclusion criteria were iatrogenic and AAST grades 4 and 5 trauma, non-conservative initial management, Hb < 10 g/dl or transfusion within the first 24 h, and patients with concomitant injuries. Patients were divided into two groups according to the length of hospital stay: ≤ 48 h (early discharge), and > 48 h (inpatient). The primary outcome was “Intervention” defined as any interventional procedure needed within the first 30 days. A Stabilized Inverse Probability of Treatment Weighting (SIPTW) propensity score based binary response model was used to estimate risk difference.Results: Out of 1764 patients with renal trauma, 311 were included in the analysis (44 in the early discharge and 267 in the inpatient group). In the early discharge group, only one patient required an intervention within the first 30 days vs. 10 in the inpatient group (3.7% vs. 5.2%; p = 0.99). Adjusted analysis using SIPTW propensity score showed a risk difference of − 2.8% [− 9.3% to + 3.7%] of “interventions” between the two groups meeting the non-inferiority criteria.Conclusion: In a highly selected cohort, early discharge management of low-grade renal trauma was not associated with an increased risk of early “intervention” compared to inpatient management. Further prospective randomized controlled trials are needed to confirm these findings.
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Dates and versions

hal-02180025 , version 1 (30-03-2020)

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Lucas Freton, Lucie-Marie Scailteux, Marine Hutin, Jonathan Olivier, Quentin Langouet, et al.. Early discharge in selected patients with low-grade renal trauma. World Journal of Urology, 2020, 38 (4), pp.1009-1015. ⟨10.1007/s00345-019-02855-y⟩. ⟨hal-02180025⟩
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