Risk factors and outcome of acute kidney injury in elderly trauma patients

Broughton-Miller, Kimberly; Frisbie, Michelle; Wojcik, Jodi; Pentecost, Karina; Doan, Regina; Nash, Nicholas A.; Miller, Keith R.

doi:10.1016/j.amjsurg.2019.02.007

Cited by 12 publications

(5 citation statements)

References 20 publications

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“…[10] However, a recent study on trauma patients aged ≥75 years found that AKI was associated with the magnitude of injury and shock, rather than the patient's comorbidities, as well as the risk of death. [11] In our study, age was analyzed as a potential risk factor; however, we did not find that it was a significant factor.…”

Section: Discussionmentioning

confidence: 57%

“…Patients aged >65 years are mainly admitted to trauma ICUs for low-energy falls and for admissions relating to their comorbidities, which may affect baseline renal function [10] . However, a recent study on trauma patients aged ≥75 years found that AKI was associated with the magnitude of injury and shock, rather than the patient's comorbidities, as well as the risk of death [11] . In our study, age was analyzed as a potential risk factor; however, we did not find that it was a significant factor.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors for acute kidney injury in critically ill patients with torso injury

et al. 2021

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Risk factors for acute kidney injury in critically ill patients with torso injury

et al. 2021

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“…Second, compared with the CENTER-TBI study [ 8 ], our patients were older (and older age is a well-known risk factor for developing AKI [ 3 ]). In injured patients aged ≥75 years, AKI was associated with the severity of injury and shock rather than comorbidities and with increased risk of death [ 14 ]. On the other hand, patients in the CENTER-TBI database were more severely injured, as noted by their higher ISS, and had major extracranial injuries in 62% of the patients, which constitutes an exclusion criterion in our sample of isolated TBI patients, as done by Luu et al [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Brain Injury and Acute Kidney Injury—Outcomes and Associated Risk Factors

Barea‐Mendoza

Chico‐Fernández

Quintana-Díaz

et al. 2022

JCM

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Our objective was to analyze the contribution of acute kidney injury (AKI) to the mortality of isolated TBI patients and its associated risk factors. Observational, prospective and multicenter registry (RETRAUCI) methods were used, from March 2015 to December 2019. Isolated TBI was defined as abbreviated injury scale (AIS) ≥ 3 head with no additional score ≥ 3. A comparison of groups was conducted using the Wilcoxon test, chi-square test or Fisher’s exact test, as appropriate. A multiple logistic regression analysis was conducted to analyze associated risk factors in the development of AKI. For the result, overall, 2964 (30.2%) had AIS head ≥ 3 with no other area with AIS ≥ 3. The mean age was 54.7 (SD 19.5) years, 76% were men, and the ground-level falls was 49.1%. The mean ISS was 18.4 (SD 8). The in-hospital mortality was 22.2%. Up to 310 patients (10.6%) developed AKI, which was associated with increased mortality (39% vs. 17%, adjusted OR 2.2). Associated risk factors (odds ratio (OR) (95% confidence interval)) were age (OR 1.02 (1.01–1.02)), hemodynamic instability (OR 2.87 to OR 5.83 (1.79–13.1)), rhabdomyolysis (OR 2.94 (1.69–5.11)), trauma-associated coagulopathy (OR 1.67 (1.05–2.66)) and transfusion of packed red-blood-cell concentrates (OR 1.76 (1.12–2.76)). In conclusion, AKI occurred in 10.6% of isolated TBI patients and was associated with increased mortality.

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“…Patients with renal trauma following traumatic injuries experience longer hospital stays and higher mortality rates [6, 7]. While the incidence and mechanisms behind kidney injury are well known, the mortality from kidney injury and the risk factors behind these deaths remains unclear [6-9]. Identification of highest risk patients for early death would facilitate implementation of preventive and potential therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

Who Is at Risk of Death after Renal Trauma? An Analysis of Thirty-Day Mortality after 1,799 Cases of Renal Trauma

et al. 2022

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Introduction: The aim of the study was to report the 30-day mortality (30DM) after renal trauma and identify the risk factors associated with death. Methods: The TRAUMAFUF project was a retrospective multi-institutional study including all patients with renal trauma admitted to 17 French hospitals between 2005 and 2015. The included population focused on patients of all age groups who underwent renal trauma during the study period. The primary outcome was death within 30 days following trauma. The multivariate logistic regression model with a stepwise backward elimination was used to identify predictive factors of 30DM. Results: Data on 1,799 renal trauma were recorded over the 10-year period. There were 59 deaths within 30 days of renal trauma, conferring a 30DM rate of 3.27%. Renal trauma was directly involved in 5 deaths (8.5% of all deaths, 0.3% of all renal trauma). Multivariate stepwise logistic regression analysis revealed that age >40 years (odds ratio [OR] 2.18; 95% confidence interval [CI]: 1.20–3.99; p = 0.01), hemodynamic instability (OR 4.67; 95% CI: 2.49–9; p < 0.001), anemia (OR 3.89; 95% CI: 1.94–8.37; p < 0.001), bilateral renal trauma (OR 6.77; 95% CI: 2.83–15.61; p < 0.001), arterial contrast extravasation (OR 2.09; 95% CI: 1.09–3.96; p = 0.02), and concomitant visceral and bone injuries (OR 6.57; 95% CI: 2.41–23.14; p < 0.001) were independent predictors of 30DM. Conclusion: Our large multi-institutional study supports that the 30DM of 3.27% after renal trauma is due to the high degree of associated injuries and was rarely a consequence of renal trauma alone. Age >40 years, hemodynamic instability, anemia, bilateral renal trauma, arterial contrast extravasation, and concomitant visceral and bone lesions were predictors of death. These results can help clinicians to identify high-risk patients.

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Risk factors and outcome of acute kidney injury in elderly trauma patients

Cited by 12 publications

References 20 publications

Risk factors for acute kidney injury in critically ill patients with torso injury

Risk factors for acute kidney injury in critically ill patients with torso injury

Traumatic Brain Injury and Acute Kidney Injury—Outcomes and Associated Risk Factors

Who Is at Risk of Death after Renal Trauma? An Analysis of Thirty-Day Mortality after 1,799 Cases of Renal Trauma

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