{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:57:07Z","timestamp":1790582227838,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The Japanese Association for the Surgery of Trauma (JAST) renal trauma classification is widely used in Japan but has not been validated using nationwide multicenter data. This study aimed to assess its clinical validity in blunt renal trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using 2019\u20132024 data from the Japan Trauma Data Bank (JTDB), a nationwide multicenter trauma registry. Among 1256 renal trauma patients in the JTDB, we included those with isolated JAST Type 3 blunt renal trauma (severe parenchymal renal trauma) and classified them as Type 3a or 3b. Multivariable logistic regression was used to identify factors associated with operative management (OM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 219 patients (Type 3a trauma,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009136; Type 3b trauma,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200983), OM was more frequent in Type 3b (14.5% vs. 2.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). In multivariable analysis, shock on arrival (odds ratio [OR], 7.96; 95% confidence interval [CI], 2.11\u201330.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and Type 3b trauma (OR, 4.49; 95% CI, 1.35\u201314.96;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) were independently associated with OM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This nationwide multicenter cohort study demonstrated that JAST Type 3b trauma was independently associated with OM in patients with blunt renal trauma. The JAST Type 3 subclassification provides clinically relevant information for predicting the need for OM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70632","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:26:01Z","timestamp":1789010761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the Japanese Association for the Surgery of Trauma Type 3 Subclassification of Renal Trauma Using the Japan Trauma Data Bank"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3092-1014","authenticated-orcid":false,"given":"Masato","family":"Yanagi","sequence":"first","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1820-2463","authenticated-orcid":false,"given":"Ryuta","family":"Nakae","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4556-6601","authenticated-orcid":false,"given":"Hayato","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0787-9321","authenticated-orcid":false,"given":"Yuki","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Toyama","sequence":"additional","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-704X","authenticated-orcid":false,"given":"Shoji","family":"Yokobori","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2671-7064","authenticated-orcid":false,"given":"Jun","family":"Akatsuka","sequence":"additional","affiliation":[{"name":"Department of Urology Nippon Medical School Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"issue":"4","key":"e_1_2_11_2_1","article-title":"Patterns, Severity, and Outcomes of Solid Organ Injuries in Abdominal Trauma: A Prospective Observational Study","volume":"18","author":"Sharma S.","year":"2026","journal-title":"Cureus"},{"issue":"2","key":"e_1_2_11_3_1","first-page":"493","article-title":"The Literature Increasingly Supports Expectant Management of Renal Trauma\u2014A Systematic Review","volume":"59","author":"Santucci R. A.","year":"2005","journal-title":"Journal of Trauma"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00329-w"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1272\/jnms.JNMS.2018_85-31"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14752"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002475"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-026-47007-6"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002572"},{"issue":"1","key":"e_1_2_11_10_1","first-page":"35","article-title":"Revision of Current American Association for the Surgery of Trauma Renal Injury Grading System","volume":"70","author":"Buckley J. C.","year":"2011","journal-title":"Journal of Trauma"},{"issue":"4","key":"e_1_2_11_11_1","first-page":"933","article-title":"Evidence\u2010Based Validation of the Predictive Value of the American Association for the Surgery of Trauma Kidney Injury Scale","volume":"62","author":"Shariat S. F.","year":"2007","journal-title":"Journal of Trauma"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2009.02392.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15331"},{"key":"e_1_2_11_14_1","unstructured":"Japan Trauma Data Bank Report \u201cJapan Trauma Data Bank Report 2022. Tokyo: Japan Trauma Data Bank 2022 \u201davailable from https:\/\/www.jtcr\u2010jatec.org\/traumabank\/dataroom\/data\/JTDB2022.pdf."},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2012.02978.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.07.100"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000004509"}],"container-title":["International Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70632","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iju.70632","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T07:29:21Z","timestamp":1790580561000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iju.70632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":16,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/iju.70632"],"URL":"https:\/\/doi.org\/10.1111\/iju.70632","archive":["Portico"],"relation":{},"ISSN":["0919-8172","1442-2042"],"issn-type":[{"value":"0919-8172","type":"print"},{"value":"1442-2042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-07-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70632"}}