Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients

OBJECTIVE: To determine the incidence and effect on mortality of early acute kidney injury in severely injured trauma patients using the Acute Kidney Injury Network creatinine criteria. DESIGN: A retrospective cohort study of severely injured trauma patients admitted to the shock trauma intensive ca...

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Autores principales: Podoll, Amber S., Kozar, Rosemary, Holcomb, John B., Finkel, Kevin W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798394/
https://www.ncbi.nlm.nih.gov/pubmed/24146987
http://dx.doi.org/10.1371/journal.pone.0077376
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author Podoll, Amber S.
Kozar, Rosemary
Holcomb, John B.
Finkel, Kevin W.
author_facet Podoll, Amber S.
Kozar, Rosemary
Holcomb, John B.
Finkel, Kevin W.
author_sort Podoll, Amber S.
collection PubMed
description OBJECTIVE: To determine the incidence and effect on mortality of early acute kidney injury in severely injured trauma patients using the Acute Kidney Injury Network creatinine criteria. DESIGN: A retrospective cohort study of severely injured trauma patients admitted to the shock trauma intensive care unit. SETTING: Texas Trauma Institute, a state designated level I trauma unit certified by the American College of Surgeons Committee on Trauma. PATIENTS: 901 severely injured trauma patients admitted over a 15 month period to the shock trauma intensive care unit. INTERVENTIONS: Retrospective analysis of prospectively collected data abstracted from an electronic trauma database. MEASUREMENTS AND MAIN RESULTS: Of 901 eligible patients admitted to the shock trauma intensive care unit after traumatic injury, 54 patients (6%) developed acute kidney injury, of whom 10 (19%) required renal replacement therapy. The 30-day mortality rate for the entire cohort was 83/901 (9.2%). Patients with early acute kidney injury had a mortality rate of 16/54 (29.6%). When corrected for multiple covariates including injury severity scores, the development of early acute kidney injury was associated with a significantly higher risk of death at 30 days with an OR of 3.4 (95% CI 1.6-7.4). CONCLUSIONS: Applying the Acute Kidney Injury Network creatinine criteria in severely injured trauma patients, the incidence of early acute kidney injury was 6%. After correction for injury severity, development of early acute kidney injury was independently associated with significantly higher 30-day mortality.
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spelling pubmed-37983942013-10-21 Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients Podoll, Amber S. Kozar, Rosemary Holcomb, John B. Finkel, Kevin W. PLoS One Research Article OBJECTIVE: To determine the incidence and effect on mortality of early acute kidney injury in severely injured trauma patients using the Acute Kidney Injury Network creatinine criteria. DESIGN: A retrospective cohort study of severely injured trauma patients admitted to the shock trauma intensive care unit. SETTING: Texas Trauma Institute, a state designated level I trauma unit certified by the American College of Surgeons Committee on Trauma. PATIENTS: 901 severely injured trauma patients admitted over a 15 month period to the shock trauma intensive care unit. INTERVENTIONS: Retrospective analysis of prospectively collected data abstracted from an electronic trauma database. MEASUREMENTS AND MAIN RESULTS: Of 901 eligible patients admitted to the shock trauma intensive care unit after traumatic injury, 54 patients (6%) developed acute kidney injury, of whom 10 (19%) required renal replacement therapy. The 30-day mortality rate for the entire cohort was 83/901 (9.2%). Patients with early acute kidney injury had a mortality rate of 16/54 (29.6%). When corrected for multiple covariates including injury severity scores, the development of early acute kidney injury was associated with a significantly higher risk of death at 30 days with an OR of 3.4 (95% CI 1.6-7.4). CONCLUSIONS: Applying the Acute Kidney Injury Network creatinine criteria in severely injured trauma patients, the incidence of early acute kidney injury was 6%. After correction for injury severity, development of early acute kidney injury was independently associated with significantly higher 30-day mortality. Public Library of Science 2013-10-17 /pmc/articles/PMC3798394/ /pubmed/24146987 http://dx.doi.org/10.1371/journal.pone.0077376 Text en © 2013 Podoll et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Podoll, Amber S.
Kozar, Rosemary
Holcomb, John B.
Finkel, Kevin W.
Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients
title Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients
title_full Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients
title_fullStr Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients
title_full_unstemmed Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients
title_short Incidence and Outcome of Early Acute Kidney Injury in Critically-Ill Trauma Patients
title_sort incidence and outcome of early acute kidney injury in critically-ill trauma patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798394/
https://www.ncbi.nlm.nih.gov/pubmed/24146987
http://dx.doi.org/10.1371/journal.pone.0077376
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