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

Alberto F. García; Ramiro Manzano-Nunez; Juan G. Bayona; Maria P. Naranjo; Dary Neicce Villa; Manuel Moreno; Sebastian Ossa; Juan M. Martinez; Nathalia Martinez; Juan C. Puyana

doi:10.1186/s40779-020-00277-1

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

Alberto F. García, Ramiro Manzano-Nunez, Juan G. Bayona, Maria P. Naranjo, Dary Neicce Villa, Manuel Moreno, Sebastian Ossa, Juan M. Martinez, Nathalia Martinez, Juan C. Puyana

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Resumen

Background
Our 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.

Methods
For 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.

Results
A 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.

Idioma original	Inglés estadounidense
Número de artículo	47
Número de páginas	6
Publicación	Military Medical Research
Volumen	7
N.º	1
DOI	https://doi.org/10.1186/s40779-020-00277-1
Estado	Publicada - oct. 9 2020
Publicado de forma externa	Sí

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@article{aa3753ef773d433d80d89ba534485d96,

title = "Acute kidney injury in severely injured patients admitted to the intensive care unit",

abstract = "Background: Our 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. Methods: For this retrospective observational study, we analyzed adult trauma patients admitted to the ICU from 2011 to 2015 at Fundaci{\'o}n 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. Results: A 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. Conclusion: We 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. ",

author = "Garc{\'i}a, {Alberto F.} and Ramiro Manzano-Nunez and Bayona, {Juan G.} and Naranjo, {Maria P.} and Villa, {Dary Neicce} and Manuel Moreno and Sebastian Ossa and Martinez, {Juan M.} and Nathalia Martinez and Puyana, {Juan C.}",

note = "Funding Information: This work was supported in part by the National Institutes of Health John E. Fogarty International Center grant#D43 TW007560. The funding organization had no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript. Publisher Copyright: {\textcopyright} 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = oct,

day = "9",

doi = "10.1186/s40779-020-00277-1",

language = "English (US)",

volume = "7",

journal = "Military Medical Research",

issn = "2095-7467",

publisher = "BioMed Central",

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TY - JOUR

T1 - Acute kidney injury in severely injured patients admitted to the intensive care unit

AU - García, Alberto F.

AU - Manzano-Nunez, Ramiro

AU - Bayona, Juan G.

AU - Naranjo, Maria P.

AU - Villa, Dary Neicce

AU - Moreno, Manuel

AU - Ossa, Sebastian

AU - Martinez, Juan M.

AU - Martinez, Nathalia

AU - Puyana, Juan C.

N1 - Funding Information: This work was supported in part by the National Institutes of Health John E. Fogarty International Center grant#D43 TW007560. The funding organization had no role in the design and conduct of the study, in the collection, management, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/10/9

Y1 - 2020/10/9

N2 - Background: Our 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. Methods: For 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. Results: A 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. Conclusion: We 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.

AB - Background: Our 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. Methods: For 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. Results: A 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. Conclusion: We 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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U2 - 10.1186/s40779-020-00277-1

DO - 10.1186/s40779-020-00277-1

M3 - Article

C2 - 33036667

AN - SCOPUS:85092460219

SN - 2095-7467

VL - 7

JO - Military Medical Research

JF - Military Medical Research

IS - 1

M1 - 47

ER -

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

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