Epidemiology and outcome of an acute kidney injuries in the polytrauma victims admitted at the apex trauma center in Dubai
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes. Methods This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai. Results The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150–1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00–1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05–1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001). Conclusions After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.
Abstract
Background Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes. Methods This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai. Results The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150–1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00–1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05–1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001). Conclusions After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.
참고문헌 (29)
- Elessawy F, "The boom : population and urban growth of Dubai city", Horizons Hum Soc Sci, 2, pp.26~41 (2017)
- Bener A, "Road traffic accidents in the United Arab Emirates compared to Western countries", Adv Transp Stud Int J, 6, pp.5~12 (2005)
- Barss P, "Occupational injury in the United Arab Emirates : epidemiology and prevention", Occup Med(Lond), 59, pp.493~498 (2009)
- Perkins ZB, "Trauma induced acute kidney injury", PLoS One, 14, pp.e0211001~ (2019)
- Don Bosco D, "Acute kidney injury in severe trauma patients : a record-based retrospective study", Adv J Emerg Med, 3, pp.e22~ (2019)
- Muhamedhussein MS, "Prevalence and risk factors of acute kidney injury in polytrauma patients at Muhimbili Orthopedic Institute, Tanzania", Afr J Emerg Med, 11, pp.74~78 (2021)
- Ahmed N, "Risk of severe acute kidney injury in multiple trauma patients : risk estimation based on a national trauma dataset", Injury, 51, pp.45~50 (2020)
- Søvik S, "Acute kidney injury in trauma patients admitted to the ICU : a systematic review and meta-analysis", Intensive Care Med, 45, pp.407~419 (2019)
- Quan H, "Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries", Am J Epidemiol, 173, pp.676~682 (2011)
- Copes WS, "The Injury Severity Score revisited", J Trauma, 28, pp.69~77 (1988)
- Patil V, "Massive transfusion and massive transfusion protocol", Indian J Anaesth, 58, pp.590~595 (2014)
- Cabral BM, "Rhabdomyolysis", Dis Mon, 66, pp.101015~ (2020)
- Martin D, "Defining major surgery : a Delphi consensus among European Surgical Association(ESA)members", World J Surg, 44, pp.2211~2219 (2020)
- Kellum JA, "Diagnosis, evaluation, and management of acute kidney injury : a KDIGO summary(Part 1)", Crit Care, 17, pp.204~ (2013)
- Sosa G, "Abdominal compartment syndrome", Dis Mon, 65, pp.5~19 (2019)
- Chawla LS, "Acute kidney disease and renal recovery : consensus report of the Acute Disease Quality Initiative(ADQI)16 Workgroup", Nat Rev Nephrol, 13, pp.241~257 (2017)
- Tandukar S, "Continuous renal replacement therapy : who, when, why, and how", Chest, 155, pp.626~638 (2019)
- Ortega-Loubon C, "Genetic susceptibility to acute kidney injury", J Clin Med, 10, pp.3039~ (2021)
- Vilander LM, "Genetic predisposition to acute kidney injury : a systematic review", BMC Nephrol, 16, pp.197~ (2015)
- Li Y, "The mechanism of contrast-induced acute kidney injury and its association with diabetes mellitus", Contrast Media Mol Imaging, 2020, pp.3295176~ (2020)
- Prowle JR, "Postoperative acute kidney injury in adult non-cardiac surgery : joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative", Nat Rev Nephrol, 17, pp.605~618 (2021)
- Zhang L, "Correlation between coagulation fibrinolysis function and outcomes during hospitalization in patients with severe traumatic hemorrhagic shock", Emerg Med Int, 2022, pp.3775868~ (2022)
- Elgin LB, "Comparisons of trauma outcomes and injury severity score", J Trauma Nurs, 26, pp.199~207 (2019)
- Assanangkornchai N, "Characteristics of creatine kinase elevation in trauma patients and predictors of acute kidney injury", J Acute Med, 7, pp.54~60 (2017)
- Holodinsky JK, "Risk factors for intra-abdominal hypertension and abdominal compartment syndrome among adult intensive care unit patients : a systematic review and meta-analysis", Crit Care, 17, pp.R249~ (2013)
- Tiwari AR, "Study of the occurrence of intra-abdominal hypertension and abdominal compartment syndrome in patients of blunt abdominal trauma and its correlation with the clinical outcome in the above patients", World J Emerg Surg, 11, pp.9~ (2016)
- Skinner DL, "Acute kidney injury on presentation to a major trauma service is associated with poor outcomes", J Surg Res, 232, pp.376~382 (2018)
- Linn S, "Injury severity scoring and length of stay in hospital of war casualties : demonstration of an association and possible selection bias", Int J Epidemiol, 22, pp.905~910 (1993)
- Tamim H, "The injury severity score or the new injury severity score for predicting mortality, intensive care unit admission and length of hospital stay : experience from a university hospital in a developing country", Injury, 39, pp.115~120 (2008)