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KMID : 1144420230380020217
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Acute and Critical Care
2023 Volume.38 No. 2 p.217 ~ p.225
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Epidemiology and outcome of an acute kidney injuries in the polytrauma victims admitted at the apex trauma center in Dubai
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Bhushan Sudhakar Wankhade
Zeyad Faoor Alrais
Ghaya Zeyad Alrais
Ammar Mohamed Abdel Hadi
Gopala Arun Kumar Naidu
Mohammed Shahid Abbas
Ahmed Tarek Youssef Aboul Kheir
Hasan Hadad
Sundareswaran Sharma
Mohammad Sait
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Abstract
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Background Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes.
Methods This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai.
Results The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150?1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00?1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05?1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001).
Conclusions After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.
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KEYWORD
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acute kidney injury, injury severity score, multiple trauma, renal replacement therapy, rhabdomyolysis
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