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Acute Kidney Injury on Presentation to a Major Trauma Service is Associated with Poor Outcomes
David Lee Skinner1, Victor Y Kong2, Kim de Vasconcellos1
1Department of Anaesthesiology and Critical Care, School of Clinical Medicine, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
The Journal of Surgical Research
|November 23, 2018
Summary
Acute kidney injury (AKI) affects 5.6% of trauma patients in South Africa, leading to higher mortality and longer hospital stays. Early recognition and prompt management of AKI are crucial for improving outcomes in trauma care.
Area of Science:
- Nephrology
- Trauma Surgery
- Critical Care Medicine
Background:
- Acute kidney injury (AKI) presents a significant disease burden in adult trauma patients.
- Understanding AKI prevalence is crucial for tertiary trauma services in South Africa.
Purpose of the Study:
- To describe the incidence and impact of acute kidney injury (AKI) in South African adult trauma patients.
- To analyze the association between AKI and patient outcomes, including mortality and resource utilization.
Main Methods:
- Retrospective analysis of a trauma database from December 2012 to July 2017.
- Inclusion of adult patients admitted for trauma, with AKI defined by Kidney Disease Improving Global Outcomes (KDIGO) criteria.
- Review of outcome data: in-hospital mortality, ICU admission, and length of stay.
Main Results:
- 5.6% of 4266 analyzed trauma patients presented with AKI (238 cases).
- AKI was more common in blunt trauma and associated with significantly higher ICU admission rates, longer hospital stays, and increased mortality.
- AKI at presentation was an independent risk factor for mortality (OR 3.038).
Conclusions:
- Acute kidney injury is a common complication in trauma patients presenting to tertiary centers.
- The presence of AKI significantly increases morbidity and mortality in trauma patients.
- Prioritizing early recognition, prompt referral, and adequate resuscitation of at-risk trauma patients is essential.
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