Urethral injury in major trauma |
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| Affiliation: | 1. University Hospitals Birmingham, United Kingdom;2. Trauma Audit & Research Network, United Kingdom;3. Nottingham University Hospitals NHS Trust, United Kingdom;1. Trauma Research Department, Swedish Medical Center, Englewood, CO, 80113, United States;2. Trauma Research Department, St. Anthony Hospital, Lakewood, CO, 80228, United States;3. Trauma Research Department, Medical City Plano, Plano, TX, 75075, United States;4. Trauma Research Department, Penrose Hospital, Colorado Springs, CO, 80907, United States;5. Trauma Services Department, Swedish Medical Center, Englewood, CO, 80113, United States;6. Trauma Services Department, St. Anthony Hospital, Lakewood, CO, 80228, United States;7. Trauma Services Department, Penrose Hospital, Colorado Springs, CO, 80907, United States;8. Trauma Services Department, Medical City Plano, Plano TX, 75075, United States;1. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong;2. School of Medicine, Cardiff University, United Kingdom;3. Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong;4. JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong;5. Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong;6. Accident and Emergency Department, Tuen Mun Hospital, Hong Kong |
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| Abstract: | Urethral injury in major trauma is infrequent, with complex problems of diagnosis and treatment. The aims of this study are to determine the incidence and epidemiological factors relating to urethral injury in major trauma, as well as determine if any additional prognostic factors are evident within this cohort of patients. A retrospective review of patients sustaining urethral injury following major trauma was made over a 6-year period, from 2010 to 2015. Quantitative analysis was made using the national trauma registry for England and Wales, the Trauma Audit and Research Network (TARN) database, identifying all patients with injury codes for urethral injury. 165 patients with urethral injuries were identified, over 90% were male, most commonly injured during road traffic accidents and with an associated overall mortality of 12%. Urethral injury in association with pelvic fracture occurred in 136 patients (82%), representing 0.6% of all pelvic fractures, and was associated with double the rate of mortality. Urethral injury was associated with unstable pelvic fractures (LC2, LC3, APC3, VS, CM) but not with a specific pelvic fracture type. This study confirms the rare incidence of this injury in major trauma at 1 per 2 million population per year. |
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| Keywords: | Urethral Trauma Injury Pelvic Fracture Epidemiology |
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