Evidence map›Paper›PMID 40042721›Full record

ArticleInternational urology and nephrology2025

The role of non-operative management for high-grade renal injuries.

Emily M Kokush, Kunj Jain, John Fastenau, Aleksander Popovic, Meher Pandher, Alexis M Driscoll, Robert E Weiss, Evan Kovac, Ziad C Sifri, Amjad Alwaal

Abstract read
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In one paragraph

Article in International urology and nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Emily M KokushDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA. emk207@njms.rutgers.edu.
Kunj JainDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.
John FastenauDepartment of Urology, George Washington University School of Medicine, Washington, DC, USA.
Aleksander PopovicDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.
Meher PandherDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.
Alexis M DriscollDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.
Robert E WeissDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.
Evan KovacDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.
Ziad C SifriDivision of Trauma, Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Amjad AlwaalDivision of Urology, Department of Surgery, Rutgers New Jersey Medical School, 140 Bergen Street, Room G1680, Newark, NJ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to investigate the long-term outcomes of non-operative, operative, and minimally invasive surgery management of high-grade renal injuries (Grades III-V) in an underserved population at a high-volume trauma center.

methodsWe conducted a retrospective chart review of 93 patients who sustained high-grade renal trauma and presented to University Hospital, a Level 1 trauma center, between 2017 and 2022. The patients were categorized by initial management strategy: non-operative, operative, or minimally invasive surgery (endoscopic urologic and interventional radiologic procedures). Outcome variables included length of hospital stay, complications, mortality, long-term renal function, and the need for additional procedures. We analyzed associations between management strategies and outcomes, adjusting for injury mechanism and severity.

resultsNon-operative management was the most common strategy (60%), followed by operative (20%) and minimally invasive surgery (20%). Operative management was associated with a higher rate of complications and reoperations (p = 0.007) and significantly longer hospital stays (p < 0.001). Non-operative management demonstrated similar long-term renal function compared to operative and minimally invasive approaches (p = 0.087), with fewer complications. No non-operative patients required subsequent procedural management, while 32% of those initially managed operatively or minimally invasively required additional interventions.

conclusionsNon-operative management is a safe and effective approach for hemodynamically stable patients with high-grade renal trauma, leading to fewer complications and similar long-term renal outcomes compared to operative and minimally invasive strategies. These findings support renal preservation through non-operative management, especially in underserved populations.

Indexed as

KidneyAdultFemaleHumansInjury Severity ScoreLength of StayMaleMiddle AgedMinimally Invasive Surgical ProceduresRetrospective StudiesTreatment OutcomeConservative treatmentKidneyMinimally invasive surgeryPostoperative complicationsTrauma

Identifiers

PMID40042721

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.