Mario Chico-Fernández1, Jesús Abelardo Barea-Mendoza1, Txoan Ormazabal-Zabala2, Gerard Moreno-Muñoz3, Diego Pastor-Marcos4, Ana Bueno-González5, Alberto Iglesias-Santiago6, Maria Ángeles Ballesteros-Sanz7, Jon Pérez-Bárcena8, Juan Antonio Llompart-Pou9. 1. UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain. 2. Servicio de Medicina Intensiva, Hospital Universitario de Donostia, Donostia, Spain. 3. Servicio de Medicina Intensiva, Hospital Joan XXIII, Tarragona, Spain. 4. Servicio de Medicina Intensiva, Hospital Universitario Lucus Augusti, Lugo, Spain. 5. Servicio de Medicina Intensiva, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. 6. Servicio de Medicina Intensiva, UCI Neurotraumatológica, Hospital Virgen de las Nieves, Granada, Spain. 7. Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 8. Servei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain. 9. Servei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain. Electronic address: juanantonio.llompart@ssib.es.
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, multicenter sample of trauma ICU patients. MATERIALS AND METHODS: Observational, prospective and multicenter 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.
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, multicenter sample of trauma ICU patients. MATERIALS AND METHODS: Observational, prospective and multicenter 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 traumapatients 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.
Authors: Jesús Abelardo Barea-Mendoza; Mario Chico-Fernández; Manuel Quintana-Díaz; Jon Pérez-Bárcena; Luís Serviá-Goixart; Ismael Molina-Díaz; María Bringas-Bollada; Antonio Luis Ruiz-Aguilar; María Ángeles Ballesteros-Sanz; Juan Antonio Llompart-Pou Journal: J Clin Med Date: 2022-01-05 Impact factor: 4.241