Outcomes of major trauma among patients with chronic kidney disease and receiving dialysis in Nova Scotia: a retrospective analysis.
kidney
mortality
observational study
wounds and injuries
Journal
Trauma surgery & acute care open
ISSN: 2397-5776
Titre abrégé: Trauma Surg Acute Care Open
Pays: England
ID NLM: 101698646
Informations de publication
Date de publication:
2021
2021
Historique:
received:
05
01
2021
revised:
18
03
2021
accepted:
23
03
2021
entrez:
28
4
2021
pubmed:
29
4
2021
medline:
29
4
2021
Statut:
epublish
Résumé
The risk of death and complications after major trauma in patients with chronic kidney disease (CKD) is higher than in the general population, but whether this association holds true among Canadian trauma patients is unknown. To characterize patients with CKD/receiving dialysis within a regional major trauma cohort and compare their outcomes with patients without CKD. All major traumas requiring hospitalization between 2006 and 2017 were identified from a provincial trauma registry in Nova Scotia, Canada. Trauma patients with stage ≥3 CKD (estimated glomerular filtration rate <60 mL/min/1.73 m In total, 6237 trauma patients were identified, of whom 4997 lived within the regional nephrology catchment area. CKD/dialysis trauma patients (n=101; 28 on dialysis) were older than patients without CKD (n=4896), with higher rates of hypertension, diabetes, and cardiovascular disease, and had increased risk of in-hospital mortality (31% vs 11%, p<0.001). No differences were observed in injury severity, ICU LOS, or ventilator-days. After adjustment for age, sex, and injury severity, the HR for in-hospital mortality was 1.90 (95% CI 1.33 to 2.70) for CKD/dialysis compared with patients without CKD. Independent of injury severity, patients without CKD/dialysis have significantly increased risk of in-hospital mortality after major trauma.
Sections du résumé
BACKGROUND
BACKGROUND
The risk of death and complications after major trauma in patients with chronic kidney disease (CKD) is higher than in the general population, but whether this association holds true among Canadian trauma patients is unknown.
OBJECTIVES
OBJECTIVE
To characterize patients with CKD/receiving dialysis within a regional major trauma cohort and compare their outcomes with patients without CKD.
METHODS
METHODS
All major traumas requiring hospitalization between 2006 and 2017 were identified from a provincial trauma registry in Nova Scotia, Canada. Trauma patients with stage ≥3 CKD (estimated glomerular filtration rate <60 mL/min/1.73 m
RESULTS
RESULTS
In total, 6237 trauma patients were identified, of whom 4997 lived within the regional nephrology catchment area. CKD/dialysis trauma patients (n=101; 28 on dialysis) were older than patients without CKD (n=4896), with higher rates of hypertension, diabetes, and cardiovascular disease, and had increased risk of in-hospital mortality (31% vs 11%, p<0.001). No differences were observed in injury severity, ICU LOS, or ventilator-days. After adjustment for age, sex, and injury severity, the HR for in-hospital mortality was 1.90 (95% CI 1.33 to 2.70) for CKD/dialysis compared with patients without CKD.
CONCLUSION
CONCLUSIONS
Independent of injury severity, patients without CKD/dialysis have significantly increased risk of in-hospital mortality after major trauma.
Identifiants
pubmed: 33907714
doi: 10.1136/tsaco-2020-000672
pii: tsaco-2020-000672
pmc: PMC8051384
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e000672Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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