Acute kidney injury in survivors of surgery for severe traumatic brain injury: Incidence, risk factors, and outcome from a tertiary neuroscience center in India

Ahmed, Masud; Sriganesh, Kamath; Vinay, Byrappa; Gs, Rao

doi:10.3109/02688697.2015.1016892

Cited by 30 publications

(31 citation statements)

References 32 publications

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“…to 40%. [5][6][7]19,20 The incidence of AKI was 20.44% in our study. This difference may be caused by the different diagnostic criteria of AKI over the years and respective medical level in different hospitals.…”

Section: Discussionsupporting

confidence: 45%

The predictive value of RDW in AKI and mortality in patients with traumatic brain injury

Wang

et al. 2020

Clinical Laboratory Analysis

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Background Red blood cell distribution width (RDW) has been validated valuable in predicting outcome and acute kidney injury (AKI) in several clinical settings. The aim of this study was to explore whether RDW is associated with outcome and AKI in patients with traumatic brain injury (TBI). Methods Patients admitted to our hospital for TBI from January 2015 to August 2018 were included in this study. Multivariate logistic regression analysis was performed to identify risk factors of AKI and outcome in patients with TBI. The value of RDW in predicting AKI and outcome was evaluated by receiver operating characteristic (ROC) curve. Results Three hundred and eighteen patients were included in this study. The median of RDW was 14.25%. We divided subjects into two groups based on the median and compared difference of variables between two groups. The incidence of AKI and mortality was higher in high RDW (RDW > 14.25) group (31.45% vs 9.43%, P < .001; 69.81% vs 29.56%, P < .001). Spearman's method showed RDW was moderately associated with 90‐day Glasgow Outcome Scale (GOS) (P < .001). In multivariate logistic regression analysis, RDW, lymphocyte, chlorine, and serum creatinine were risk factors of AKI. And Glasgow Coma Scale (GCS), glucose, chlorine, AKI, and RDW were risk factors of mortality. The area under the ROC curve (AUC) of RDW for predicting AKI and mortality was 0.724 (0.662‐0.786) and 0.754 (0.701‐0.807), respectively. Patients with higher RDW were likely to have shorter median survival time (58 vs 70, P < .001). Conclusions Red blood cell distribution width is an independent risk factor of AKI and mortality in patients with TBI.

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Section: Discussionsupporting

confidence: 45%

The predictive value of RDW in AKI and mortality in patients with traumatic brain injury

Wang

et al. 2020

Clinical Laboratory Analysis

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“…The incidence of AKI in our study is similar to those reported among several non-cardiac surgery cohorts, which varied from 7.5% to 24% 2, 5, 12, 13 , but lower than those in cardiac surgery 4, 17 . Although several studies had reported the incidence of AKI in traumatic brain injury cohorts, ranging from 8% to 25% 18–21 , the postoperative AKI incidence of entire neurosurgical critically ill cohort has not been well described. Our investigation provided more evidences regarding incidence of postoperative AKI in such specific population.…”

Section: Discussionmentioning

confidence: 99%

The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients

Deng

Yuan

Chi

et al. 2017

Sci Rep

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We investigated the incidence, perioperative risk factors, and outcomes of postoperative acute kidney injury (AKI) in neurosurgical critically ill patients. A prospective multicenter cohort study was conducted, enrolling adult patients who underwent neurosurgical procedure and admitted to the neurosurgical intensive care units (ICU). Postoperative AKI was diagnosed within 7 days after surgery based on the Kidney Disease Improving Global Outcomes criteria. Of 624 enrolled patients, postoperative AKI occurred in 84 patients. AKI was associated with increased rates of ICU and in-hospital mortality, postoperative renal replacement therapy, postoperative tracheotomy, and postoperative tracheal reintubation. Patients who developed AKI had higher total ICU costs, prolonged length of hospital and ICU stay, and longer duration of postoperative mechanical ventilation. Multivariate analysis identified postoperative reoperation (adjusted odds ratio [OR] 5.70 [95% CI, 1.61–20.14]), postoperative concentration of serum cystatin C (adjusted OR 4.53 [95% CI, 1.98–10.39]), use of mannitol during operation (adjusted OR 1.97 [95% CI, 1.13–3.43]), postoperative APACHE II score (adjusted OR 1.11 [95% CI, 1.06–1.16]), and intraoperative estimated blood loss (adjusted OR 1.04 [95% CI, 1.00–1.08]) as independent risk factors for postoperative AKI. Postoperative AKI in neurosurgical critically ill cohort is prevalent and associated with adverse in-hospital outcomes.

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“…However, physiologically body constantly excrete sodium after brain cells death due to sodium waste mechanism of the brain, which called sodium-wasting mechanism of brain. 8 Authors made this paper by following the guideline from PRISMA and Cochrane. 9,10 Higgins et al, said AKI occurrence was not a rare finding in stroke patients.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Atherosclerosis, arterial hypertension, and diebetes mellitus whereas risk factors of cerebrovascular accident are common predisposing condition to create AKI. 8 Regarding the data spreaded, there were still minimal observation and the accumulative reports of CVA progress to AKI. Therefore, the objective of this metaanalysis was to evaluate the renal impairment following ischemic cerebrovascular accident (CVA) patients worldwide in order to comprehensively acknowledge prevalence of AKI following stroke and the clinical consequences on morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Ischemic cerebrovascular accident and its secondary renal impairment

Permana

Purnomo

2018

Int J Adv Med

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Background: Renal impairment is one of the most frequent but anticipated potential complications. The objective of this meta-analysis was to evaluate the renal impairment following ischemic cerebrovascular accident (CVA) patients worldwide.Methods: Authors were using meta-analysis. Studies were obtained from several databases like Pubmed, Cochrane, Karger and JNS. Keywords were "renal" or "kidney" and "stroke" and "ischemic". Included studies were full-text observational study or randomized control trial (RCT). Subjects in study were newly diagnosed acute kidney disease (AKI) after ischemic CVA, with age range 18-100 years old. From 425 studies, total 5 studies were eligible for this study.Results: From those 5 studies, it is shown that the pooled risk ratio (RR) for mortality ischemic CVA with AKI was 2.56. AKI appeared insignificantly in both ischemic CVA and intracerebral haemorrhage (ICH) (RR 0.75; p=0.01). The pooled risk ratio had wide heterogeneity (I2 = 0.95) so random effect model was used.Conclusions: Renal impairment and its mortality appeared more frequent in ischemic CVA with AKI. It still needs more multicentre and long-term period researches in the future to get better understanding AKI in ischemic CVA.

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Acute kidney injury in survivors of surgery for severe traumatic brain injury: Incidence, risk factors, and outcome from a tertiary neuroscience center in India

Cited by 30 publications

References 32 publications

The predictive value of RDW in AKI and mortality in patients with traumatic brain injury

The predictive value of RDW in AKI and mortality in patients with traumatic brain injury

The Incidence, Risk Factors and Outcomes of Postoperative Acute Kidney Injury in Neurosurgical Critically Ill Patients

Ischemic cerebrovascular accident and its secondary renal impairment

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