Citation

Chico-Fernández M, Barea-Mendoza JA, Ormazabal-Zabala T, Moreno-Muñoz G, Pastor-Marcos D, Bueno-González A, Iglesias-Santiago A, Ballesteros-Sanz MÁ, Pérez-Bárcena J, Llompart-Pou JA. Anaesth. Crit. Care Pain Med. 2020; ePub(ePub): ePub.

Affiliation

Servei de Medicina Intensiva, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain. Electronic address: juanantonio.llompart@ssib.es.

Copyright

(Copyright © 2020, Société française d'anesthésie et de réanimation, Publisher Elsevier Publishing)

DOI

10.1016/j.accpm.2019.11.003

PMID

32289531

Abstract

INTRODUCTION: Acute kidney injury (AKI) constitutes a common complication after severe trauma. Our objective was to analyse the associated risk factors and outcomes of AKI in a large, multicenter sample of trauma ICU patients.

MATERIALS AND METHODS: Observational, prospective and multicenter nationwide registry (RETRAUCI). We included all patients admitted to the participating ICUs from November 2013 to May 2017. We analysed the impact of AKI evaluated by the Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE) definition. Comparison of groups was performed using Wilcoxon test, Chi-Square Test or Fisher's exact test as appropriate. A multiple logistic regression analysis was performed to analyse associated factors to the development of AKI. Logistic regression was used to calculate AKI-related mortality. A p value < 0.05 was considered significant.

RESULTS: During the study period, 5882 trauma patients were admitted. Complete data were available for 5740 patients. Among them, 871 had AKI (15.17%), distributed by RIFLE R 458 (7.98%), RIFLE I 234 (4.08%) and RIFLE F 179 (3.12%). Associated risk factors were: age (OR 3.05), haemodynamic instability (OR 2.90 to OR 8.34 depending on the severity of hypotension), coagulopathy (OR 1.82), rhabdomyolysis (OR 4.67) and AIS abdomen (OR 1.54). AKI was associated with mortality (crude OR 1.93 (1.59-2.36)), even after adjusting by potential confounders (adjusted OR 1.40 (1.13-1.73)).

CONCLUSION: In our large sample of trauma ICU patients we found an incidence of AKI of 15%, which was associated with an increased mortality.

Copyright © 2020. Published by Elsevier Masson SAS.

Language: en

Keywords

Severe trauma; acute kidney injury; intensive care; mortality; outcomes