NDLI: A Multi-Center Evaluation of Early Acute Kidney Injury in Critically Ill Trauma Patients

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A Multi-Center Evaluation of Early Acute Kidney Injury in Critically Ill Trauma Patients

Content Provider	Taylor & Francis Online
Author	Bellomo, Rinaldo Bagshaw, Sean M. George, Carol Gibney, R. T. Noel
Abstract	Rationale. Few studies have evaluated the epidemiology of acute kidney injury (AKI) in trauma. Objective. To evaluate the incidence, risk factors, and outcomes associated with early AKI (evident within 24 hours of admission) in critically ill trauma patients. Methods. A retrospective interrogation of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. A total of 9,449 trauma patients were admitted for ≥24 hours to 57 intensive care units across Australia from January 1st, 2000, to December 31st, 2005. Main Findings. The crude incidence of AKI was 18.1% (n = 1,711). Older age, female sex (OR 1.60, 95% CI, 1.43–1.78, p < 0.0001), and the presence of co-morbid illness (OR 2.70, 95% CI 2.3–3.2, p < 0.0001) were associated with higher odds of AKI. Those with trauma not associated with brain injury (OR 2.40, 95% CI, 2.1–2.7, p < 0.0001) and a higher illness severity (OR 1.12, 95% CI, 1.11–1.12, p < 0.001) also had higher likelihood of AKI. Overall, AKI was associated with a higher crude mortality (16.7% vs. 7.8%, OR 2.36, 95% CI, 2.0–2.7, p < 0.001). Each RIFLE category of AKI was independently associated with hospital mortality in multi-variable analysis (risk: OR 1.69; injury OR 1.88; failure 2.29). Conclusions. Trauma admissions to ICU are frequently complicated by early AKI. Those at high risk for AKI appear to be older, female, with co-morbid illnesses, and present with greater illness severity. Early AKI in trauma is also independently associated with higher mortality. These data indicate a higher burden of AKI than previously described.
Starting Page	581
Ending Page	589
Page Count	9
File Format	PDF HTM / HTML
ISSN	0886022X 15256049
DOI	10.1080/08860220802134649
Journal	Renal Failure
Volume Number	30
Issue Number	6
Language	English
Publisher	Taylor & Francis
Publisher Date	2009-07-07
Access Restriction	Open
Subject Keyword	Acute kidney injury Acute renal failure Trauma Incidence Multi-centre
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine Nephrology

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