Acute kidney injury in severely injured patients admitted to the intensive care unit

Military Medical Research

Juan C. Puyana¹  Maria P. Naranjo²  Dary Neicce Villa²  Juan G. Bayona²  Alberto F. García²  Ramiro Manzano-Nunez³  Juan M. Martinez⁴  Manuel Moreno⁴  Sebastian Ossa⁴  Nathalia Martinez⁴ 

[1] Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA;Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili, Cali, Colombia;Clinical Research Center, Fundación Valle del Lili, Cali, Colombia;Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Carrera 98 #18-49, 760001, Bogotá, Colombia;Méderi Hospital Universitario Mayor, Bogotá, Colombia;School of Medicine, Universidad ICESI (ICESI University), Cali, Colombia;

关键词: Rhabdomyolysis;    Wounds and injuries;    Acute kidney injury;    Critical care;    Trauma;   

DOI  :  10.1186/s40779-020-00277-1

来源: Springer

【 摘 要 】

BackgroundOur objective was to identify possible associations between clinical and laboratory variables and the risk of developing acute kidney injury (AKI) in severely injured patients admitted to the intensive care unit (ICU) for whom creatine kinase (CK) levels were available.MethodsFor this retrospective observational study, we analyzed adult trauma patients admitted to the ICU from 2011 to 2015 at Fundación Valle del Lili (FVL) University Hospital. Our primary outcome was the incidence of AKI. Multivariate regression analysis was used to assess risk factors for this outcome.ResultsA total of 315 patients were included. The trauma mechanisms were blunt (n = 130), penetrating (n = 66) and blast (n = 44) trauma. The median (interquartile range, IQR) of injury severity score (ISS) was 21 (16–29). AKI developed in 75 patients (23.8%). Multivariate regression analysis revealed that the thoracic abbreviated injury scale (AIS) value (median (IQR) in the AKI group: 3 (0–4)), Acute Physiology and Chronic Health Evaluation (APACHE II) score (median (IQR) in the AKI group: 18 (10–27)), CK greater than 5000 U/L, lactic acid concentration at admission, and dobutamine administration were independently associated with AKI.ConclusionWe found that age, APACHE II score, thoracic trauma, lactic acidosis, and dobutamine administration were independently associated with AKI. Trauma surgeons need to be aware of the increased odds of AKI if one of these factors is identified during the evaluation and treatment of injured patients.

【 授权许可】

CC BY