Dugi et al subclassified Grade 4 renal injury into 2 risk categories based on three observations. The authors are from the University of Texas Southwestern in Dallas.
Patient selection: Grade 4 renal injury
Parameters:
(1) perirenal hematoma size in cm
(2) extravasation of intravascular contrast
(3) medial renal laceration
Parameter
Finding
Points
perirenal hematoma
<= 3.5 cm
0
> 3.5 cm
1
extravasation of contrast
absent
0
present
1
medial renal laceration
absent
0
present
1
number of risk factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
Number of Risk Factors
Designation
Risk Category
Surgery
0 or 1
4a
low
7%
2 or 3
4b
high
67%
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