Implementation of a clinical guideline for nonoperative management of isolated blunt renal injury in children

Background: The aim was to evaluate the impact of a standardized nonoperative management protocol by comparing patients with isolated blunt renal injury before and after implementation. Methods: We retrospectively reviewed the trauma registry at our Level 1 pediatric trauma center. We compared consecutive patients (<= 18 years) managed nonoperatively for blunt renal injury Pre (1/2010-9/2014) and Post (10/2014-3/2020) implementation of a clinical guideline. Outcomes included length of stay, intensive care unit admission, urinary catheter use, and imaging studies. Results: We included 48 patients with isolated blunt renal injuries (29 Pre, 19 Post). There were no differences in age, sex, injury grade, or mechanism (P >.05). Postprotocol had decreased length of stay (P=.040), intensive care unit admissions (P=.015), urinary catheter use (P=.031), and ionizing radiation imaging (P <.001). Conclusion: These data suggest improved outcomes and resource utilization following implementation of a nonoperative management protocol of pediatric isolated blunt renal injuries. (C) 2021 The Author(s). Published by Elsevier Inc.