Risk Factors and Outcomes of Acute Kidney Injury in Trauma Patients Admitted to Critical Care Units

Document Type : Original Article

Authors

1 Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Department of Physiology, The Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

10.30491/tm.2023.397512.1598

Abstract

Introduction: This study aimed to determine the AKI prevalence and the contributing factors among trauma patients admitted to the ICU of the only level-one trauma center in south Iran.
Methods: The present study was a retrospective cohort of patients with post-traumatic AKI admitted to the intensive care units of Shahid Rajaee (Emtiaz) Trauma Hospital in Shiraz, Iran, between March 21, 2021, and February 20, 2022. The variables were obtained from the Iran Intensive Care Unit Registry program (IICUR). Demographic features (age, sex, height, weight), vital signs including heart rate, respiratory rate, temperature, blood pressure, outcome, and laboratory findings were gathered.
Results: In total, 2271 trauma patients admitted to the ICUs were included in 398 cases (17.5%) developed with AKI. Most AKI patients, 249 (62.60%) were in stage 1 disease. Of 77(19.30%) individuals in stage 2, 72(18.10%) were in stage 3 of the disease. Most AKI patients were male, with a mean age of 52.92± 22.06 years. AKI patients were hospitalized in the intensive care unit for significantly more days than patients without AKI and were more severe regarding APACHE II and GCS (p-value <0.001).
Conclusion: Acute renal injury in ICU trauma patients is a common complication with significant mortality and length of hospital stay. Age, high APACHE II score, minimum systolic blood pressure, acute renal injury, and low GCS score are strong risk factors associated with mortality in intensive care unit patients. Patients with acute kidney injury are five times more likely to die.

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