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Acute kidney injury in severely injured patients admitted to the Intensive Care Unit

Military Medical Research 2021年第2期8卷 141-147页

作者： 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 Division of Trauma and Acute Care Surgery Department of SurgeryFundación Valle del LiliCaliColombia Clinical Research Center Fundación Valle del LiliCaliColombia Escuela de Medicina Ciencias de la SaludUniversidad del RosarioCarrera 98#18-49760001BogotaColombia Méderi Hospital Universitario Mayor Colombia School of Medicine Universidad ICESI(ICESI University)CaliColombia Department of Surgery University of PittsburghPittsburghPAUSA

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.Conclusions: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.

关键词： Rhabdomyolysis Wounds and injuries Acute kidney injury Critical care Trauma

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