Associated risk factors and outcomes of acute kidney injury in severe trauma: Results from the Spanish trauma ICU registry (RETRAUCI) - 19/08/20
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Highlights |
• | Acute kidney injury was common in our large sample of trauma ICU patients. |
• | Age, haemodynamic instability, coagulopathy, rhabdomyolysis and AIS abdomen>3 were associated risk factors to acute kidney injury. |
• | Acute kidney injury was associated with mortality after adjustment by age, sex and severity of injury. |
Abstract |
Introduction |
Acute kidney injury (AKI) constitutes a common complication after severe trauma. Our objective was to analyse the associated risk factors and outcomes of AKI in a large, multicentre sample of trauma ICU patients.
Materials and methods |
Observational, prospective and multicentre nationwide registry (RETRAUCI). We included all patients admitted to the participating ICUs from November 2013 to May 2017. We analysed the impact of AKI evaluated by the Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE) definition. Comparison of groups was performed using Wilcoxon test, Chi-Square Test or Fisher's exact test as appropriate. A multiple logistic regression analysis was performed to analyse associated factors to the development of AKI. Logistic regression was used to calculate AKI-related mortality. A P value<0.05 was considered significant.
Results |
During the study period, 5882 trauma patients were admitted. Complete data were available for 5740 patients. Among them, 871 had AKI (15.17%), distributed by RIFLE R 458 (7.98%), RIFLE I 234 (4.08%) and RIFLE F 179 (3.12%). Associated risk factors were: age (OR 3.05), haemodynamic instability (OR 2.90 to OR 8.34 depending on the severity of hypotension), coagulopathy (OR 1.82), rhabdomyolysis (OR 4.67) and AIS abdomen (OR 1.54). AKI was associated with mortality (crude OR 1.93 (1.59-2.36)), even after adjusting by potential confounders (adjusted OR 1.40 (1.13-1.73)).
Conclusion |
In our large sample of trauma ICU patients we found an incidence of AKI of 15%, which was associated with an increased mortality.
Le texte complet de cet article est disponible en PDF.Keywords : Severe trauma, Acute kidney injury, Intensive care, Outcomes, Mortality
Plan
Vol 39 - N° 4
P. 503-506 - août 2020 Retour au numéro
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