Acute kidney injury in severely injured patients admitted to the intensive care unit.
APACHE
Acidosis, Lactic
/ complications
Acute Kidney Injury
/ blood
Adult
Colombia
/ epidemiology
Creatine Kinase
/ analysis
Female
Hospitalization
/ statistics & numerical data
Humans
Incidence
Injury Severity Score
Intensive Care Units
/ organization & administration
Logistic Models
Male
Retrospective Studies
Risk Factors
Wounds and Injuries
/ blood
Acute kidney injury
Critical care
Rhabdomyolysis
Trauma
Wounds and injuries
Journal
Military Medical Research
ISSN: 2054-9369
Titre abrégé: Mil Med Res
Pays: England
ID NLM: 101643181
Informations de publication
Date de publication:
09 10 2020
09 10 2020
Historique:
received:
10
02
2020
accepted:
28
09
2020
entrez:
10
10
2020
pubmed:
11
10
2020
medline:
31
3
2021
Statut:
epublish
Résumé
Our 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. For 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. A 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. We 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.
Sections du résumé
BACKGROUND
Our 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.
METHODS
For 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.
RESULTS
A 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.
CONCLUSION
We 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.
Identifiants
pubmed: 33036667
doi: 10.1186/s40779-020-00277-1
pii: 10.1186/s40779-020-00277-1
pmc: PMC7547510
doi:
Substances chimiques
Creatine Kinase
EC 2.7.3.2
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
47Subventions
Organisme : FIC NIH HHS
ID : D43 TW007560
Pays : United States
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