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Acute kidney injury in severely injured patients admitted to the intensive care unit

Authors
  • García, Alberto F.1, 2
  • Manzano-Nunez, Ramiro3, 4
  • Bayona, Juan G.1, 2
  • Naranjo, Maria P.1, 2
  • Villa, Dary Neicce1, 2
  • Moreno, Manuel5
  • Ossa, Sebastian5
  • Martinez, Juan M.5
  • Martinez, Nathalia5
  • Puyana, Juan C.6
  • 1 Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili, Cali, Colombia , Cali (Colombia)
  • 2 Clinical Research Center, Fundación Valle del Lili, Cali, Colombia , Cali (Colombia)
  • 3 Universidad del Rosario, Carrera 98 #18-49, Bogotá, 760001, Colombia , Bogotá (Colombia)
  • 4 Méderi Hospital Universitario Mayor, Bogotá, Colombia , Bogotá (Colombia)
  • 5 Universidad ICESI (ICESI University), Cali, Colombia , Cali (Colombia)
  • 6 University of Pittsburgh, Pittsburgh, PA, USA , Pittsburgh (United States)
Type
Published Article
Journal
Military Medical Research
Publisher
Springer Nature
Publication Date
Oct 09, 2020
Volume
7
Issue
1
Identifiers
DOI: 10.1186/s40779-020-00277-1
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundOur objective was to identify possible associations between clinical and laboratory variables and the risk of developing acute kidney injury (AKI) in severely injured patients admitted to the intensive care unit (ICU) for whom creatine kinase (CK) levels were available.MethodsFor this retrospective observational study, we analyzed adult trauma patients admitted to the ICU from 2011 to 2015 at Fundación Valle del Lili (FVL) University Hospital. Our primary outcome was the incidence of AKI. Multivariate regression analysis was used to assess risk factors for this outcome.ResultsA total of 315 patients were included. The trauma mechanisms were blunt (n = 130), penetrating (n = 66) and blast (n = 44) trauma. The median (interquartile range, IQR) of injury severity score (ISS) was 21 (16–29). AKI developed in 75 patients (23.8%). Multivariate regression analysis revealed that the thoracic abbreviated injury scale (AIS) value (median (IQR) in the AKI group: 3 (0–4)), Acute Physiology and Chronic Health Evaluation (APACHE II) score (median (IQR) in the AKI group: 18 (10–27)), CK greater than 5000 U/L, lactic acid concentration at admission, and dobutamine administration were independently associated with AKI.ConclusionWe found that age, APACHE II score, thoracic trauma, lactic acidosis, and dobutamine administration were independently associated with AKI. Trauma surgeons need to be aware of the increased odds of AKI if one of these factors is identified during the evaluation and treatment of injured patients.

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