Heiner SM, Keihani S, McCormick BJ, et al. - In the acute trauma setting, a higher mortality was conferred by nephrectomy even when controlling for shock, overall injury severity, and head injury.

• Via the Multi-institutional Genito-Urinary Trauma Study, data from 21 Level-1 trauma centers were obtained.

• 1,181 high-grade renal trauma patients with median age 31 and blunt trauma in 78%, were included.

• Grade III, IV, and V injuries were seen in 55%, 34%, and 11%, respectively, and there were 96 (8%) mortalities and 129 (11%) nephrectomies.

• The nephrectomy group had higher mortality (21.7% vs 6.5%).

• Older age, higher injury severity score, lower Glasgow Coma Scale, and higher rates of shock were noted in patients who died.