Trauma induced acute kidney injury

Injured patients are at risk of developing acute kidney injury (AKI), which is associated with increased morbidity and mortality. The aim of this study is to describe the incidence, timing, and severity of AKI in a large trauma population, identify risk factors for AKI, and report mortality outcomes...

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Bibliographic Details
Published in:PloS one 2019-01, Vol.14 (1), p.e0211001
Main Authors: Perkins, Zane B, Captur, Gabriella, Bird, Ruth, Gleeson, Liam, Singer, Ben, O'Brien, Benjamin
Format: Article
Language:English
Subjects:
Acute Kidney Injury - blood
Acute Kidney Injury - etiology
Acute Kidney Injury - mortality
Acute Kidney Injury - therapy
Adolescent
Adult
Adults
Aged
Aged, 80 and over
Analysis
Biology and Life Sciences
Blood cells
Blood Pressure
Complications and side effects
Creatinine
Creatinine - blood
Critical care
Disease-Free Survival
Emergency medical care
Erythrocytes
Female
Health risks
Heart
Hospitals
Humans
Incidence
Injuries
Kidney diseases
Kidneys
Lactic acid
Lactic Acid - blood
Male
Medicine and Health Sciences
Middle Aged
Morbidity
Mortality
Nephrology
Outcome and process assessment (Medical care)
Patient outcomes
Patients
Prospective Studies
Regression analysis
Renal function
Renal replacement therapy
Resuscitation
Risk analysis
Risk Factors
Sepsis
Surgery
Survival Rate
Systematic review
Trauma
Wounds and Injuries - blood
Wounds and Injuries - complications
Wounds and Injuries - mortality
Wounds and Injuries - therapy
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Summary:Injured patients are at risk of developing acute kidney injury (AKI), which is associated with increased morbidity and mortality. The aim of this study is to describe the incidence, timing, and severity of AKI in a large trauma population, identify risk factors for AKI, and report mortality outcomes. A prospective observational study of injured adults, who met local criteria for trauma team activation, and were admitted to a UK Major Trauma Centre. AKI was defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression and Cox proportional hazard modelling was used to analyse parameters associated with AKI and mortality. Of the 1410 patients enrolled in the study, 178 (12.6%) developed AKI. Age; injury severity score (ISS); admission systolic blood pressure, lactate and serum creatinine; units of Packed Red Blood Cells transfused in first 24 hours and administration of nephrotoxic therapy were identified as independent risk factors for the development of AKI. Patients that developed AKI had significantly higher mortality than those with normal renal function (47/178 [26.4%] versus 128/1232 [10.4%]; OR 3.09 [2.12 to 4.53]; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0211001