Risk of Hypertension after Renal Trauma: An Analysis of a Large Insurance Claims Database.

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-07-23 DOI:10.1016/j.urology.2025.07.045

Jane T Kurtzman, Matthew Swallow, Joshua J Horns, Tarah Woodle, Benjamin McCormick, Jeremy Myers

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引用次数: 0

Abstract

Objective: To evaluate the risk of new-onset hypertension (HTN) after renal trauma (rT) using a large insurance claims database.

Methods: We conducted a retrospective analysis of Merative MarketScan records from 2011- 2017. Patients with rT were compared to controls with isolated bladder or urethral trauma. Patients were excluded if they had both trauma types, pre-existing hypertension, < 1 year of pre-trauma enrollment data, or age < 18 years old. Kaplan-Meier curves and multivariate Cox proportional hazards models assessed HTN risk between groups.

Results: 7,882 patients (4,703 rT) were included. In total, 35% of rT patients developed de-novo HTN compared to 21% of controls (p < 0.001). Multivariate analysis demonstrated that patients who suffered rT were nearly twice as likely to develop de-novo HTN (HR 1.8, p<0.001). Patients with renal trauma managed with either angioembolization or nephrectomy were at greatest risk of HTN (HR 3.4 and 2.4, respectively, p values < 0.005). HTN risk was also associated with older age, female sex, higher Charlson Comorbidity Index, longer stay, diabetes, obesity, hyperlipidemia, and alcohol use.

Conclusions: Patients who suffer rT are at increased risk of developing de-novo HTN. Patients who undergo nephrectomy or angioembolization appear to be at the greatest risk compared to controls. Following renal trauma, patients should be counseled on the risk of new HTN and receive close monitoring of their blood pressure over time.

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肾外伤后高血压的风险：一个大型保险索赔数据库的分析。

目的：利用大型保险理赔数据库评估肾外伤（rT）后新发高血压（HTN）的风险。方法：我们对2011- 2017年Merative MarketScan记录进行回顾性分析。将rT患者与孤立性膀胱或尿道创伤的对照组进行比较。排除两种创伤类型、既往高血压、创伤前登记资料< 1年或年龄< 18岁的患者。Kaplan-Meier曲线和多变量Cox比例风险模型评估了组间HTN的风险。结果：纳入7882例患者（4703 rT）。总的来说，35%的rT患者发生了重新发生HTN，而对照组的这一比例为21% （p < 0.001）。多因素分析表明，接受rT治疗的患者发生再发HTN的可能性几乎是接受rT治疗患者的两倍（HR 1.8, p）。结论：接受rT治疗的患者发生再发HTN的风险增加。与对照组相比，接受肾切除术或血管栓塞的患者风险最大。肾外伤后，应告知患者发生新HTN的风险，并长期密切监测其血压。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.