Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury.

Acute Kidney Injury / epidemiology Brain Injuries, Traumatic / complications Humans Patient Acceptance of Health Care Retrospective Studies Risk Factors
Acute kidney injury Healthcare utilization Traumatic brain injury

Journal

Neurocritical care
ISSN: 1556-0961
Titre abrégé: Neurocrit Care
Pays: United States
ID NLM: 101156086

Informations de publication

Date de publication:
10 2021
Historique:
received: 10 09 2020
accepted: 22 12 2020
pubmed: 15 1 2021
medline: 16 11 2021
entrez: 14 1 2021
Statut: ppublish

Résumé

Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. While cardiopulmonary dysfunction can result in poor outcomes following severe TBI, the impact of acute kidney injury (AKI) is poorly understood. We examined the association of severe AKI with hospital mortality and healthcare utilization following isolate severe TBI. We conducted a retrospective cohort study using the National Trauma Data Bank from 2007 to 2014. We identified a cohort of adult patients with isolated severe TBI and described the incidence of severe AKI, corresponding to Acute Kidney Injury Network stage 3 disease or greater. We examined the association of severe AKI with the primary outcome of hospital mortality using multivariable logistic regression models. In secondary analyses, we examined the association of severe AKI with dialysis catheter placement, tracheostomy and gastrostomy utilization, and hospital length of stay. There were 37,851 patients who experienced isolated severe TBI during the study period. Among these patients, 787 (2.1%) experienced severe (Stage 3 or greater) AKI. In multivariable models, the development of severe AKI in the hospital was associated with in-hospital mortality (OR 2.03, 95% CI 1.64-2.52), need for tracheostomy (OR 2.10, 95% CI 1.52-2.89), PEG tube placement (OR 1.88, 95% CI 1.45-2.45), and increased hospital length of stay (p < 0.001). The overall incidence of severe AKI is relatively low (2.1%), but is associated with increased mortality and multiple markers of increased healthcare utilization following severe TBI.

Sections du résumé

BACKGROUND/OBJECTIVE
Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. While cardiopulmonary dysfunction can result in poor outcomes following severe TBI, the impact of acute kidney injury (AKI) is poorly understood. We examined the association of severe AKI with hospital mortality and healthcare utilization following isolate severe TBI.
METHODS
We conducted a retrospective cohort study using the National Trauma Data Bank from 2007 to 2014. We identified a cohort of adult patients with isolated severe TBI and described the incidence of severe AKI, corresponding to Acute Kidney Injury Network stage 3 disease or greater. We examined the association of severe AKI with the primary outcome of hospital mortality using multivariable logistic regression models. In secondary analyses, we examined the association of severe AKI with dialysis catheter placement, tracheostomy and gastrostomy utilization, and hospital length of stay.
RESULTS
There were 37,851 patients who experienced isolated severe TBI during the study period. Among these patients, 787 (2.1%) experienced severe (Stage 3 or greater) AKI. In multivariable models, the development of severe AKI in the hospital was associated with in-hospital mortality (OR 2.03, 95% CI 1.64-2.52), need for tracheostomy (OR 2.10, 95% CI 1.52-2.89), PEG tube placement (OR 1.88, 95% CI 1.45-2.45), and increased hospital length of stay (p < 0.001).
CONCLUSIONS
The overall incidence of severe AKI is relatively low (2.1%), but is associated with increased mortality and multiple markers of increased healthcare utilization following severe TBI.

Identifiants

DOI: 10.1007/s12028-020-01183-z PMID: 33442812 PMC: PMC8275693
pubmed: 33442812
doi: 10.1007/s12028-020-01183-z
pii: 10.1007/s12028-020-01183-z
pmc: PMC8275693
mid: NIHMS1668763
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

434-440

Subventions

Organisme : NINDS NIH HHS
ID : K23 NS109274
Pays : United States

Informations de copyright

© 2021. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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Auteurs

David Luu (D)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Jordan Komisarow (J)

Department of Neurosurgery, Duke University, Durham, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Brianna M Mills (BM)

Harborview Injury Prevention and Research Center, University of Washington, Seattle, USA.
Department of Epidemiology, University of Washington, Seattle, USA.

Monica S Vavilala (MS)

Harborview Injury Prevention and Research Center, University of Washington, Seattle, USA.
Departments of Anesthesiology and Pain Medicine, University of Washington, Seattle, USA.

Daniel T Laskowitz (DT)

Departments of Neurology, Duke University, Durham, USA.

Joseph Mathew (J)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.

Michael L James (ML)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Departments of Neurology, Duke University, Durham, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Adrian Hernandez (A)

Departments of Medicine, Duke University, Durham, USA.
Population Health Sciences, Duke University, Durham, USA.

John Sampson (J)

Department of Neurosurgery, Duke University, Durham, USA.

Matt Fuller (M)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Tetsu Ohnuma (T)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Karthik Raghunathan (K)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.
Population Health Sciences, Duke University, Durham, USA.

Jamie Privratsky (J)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Raquel Bartz (R)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA.

Vijay Krishnamoorthy (V)

Duke University Medical Center, Department of Anesthesiology, DUMC 3094, Duke University, Durham, NC, 27710, USA. vijay.krishnamoorthy@duke.edu.
Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University, Durham, USA. vijay.krishnamoorthy@duke.edu.
Population Health Sciences, Duke University, Durham, USA. vijay.krishnamoorthy@duke.edu.

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Classifications MeSH

questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Maladies du rein › Insuffisance rénale › Atteinte rénale aigüe › Association of Severe Acute Kidney Injury with...
questionsmedicales.fr › Plaies et blessures › Traumatismes du système nerveux › Traumatismes cranioencéphaliques › Lésions encéphaliques › Lésions traumatiques de l'encéphale › Association of Severe Acute Kidney Injury with...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Association of Severe Acute Kidney Injury with...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Attitude envers la santé › Adhésion et observance thérapeutiques › Acceptation des soins par les patients › Association of Severe Acute Kidney Injury with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Association of Severe Acute Kidney Injury with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Association of Severe Acute Kidney Injury with...