1. Incidence and risk factors of acute kidney injury in the Japanese trauma population: A prospective cohort study
- Author
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Akira Kuriyama, Jun Fujinaga, and Noriaki Shimada
- Subjects
Male ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Population ,Comorbidity ,urologic and male genital diseases ,law.invention ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Japan ,Risk Factors ,law ,Internal medicine ,medicine ,Humans ,Blood Transfusion ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Intensive care medicine ,Prospective cohort study ,education ,Aged ,General Environmental Science ,Aged, 80 and over ,education.field_of_study ,Trauma Severity Indices ,business.industry ,Incidence ,Incidence (epidemiology) ,Age Factors ,Acute kidney injury ,030208 emergency & critical care medicine ,Odds ratio ,Acute Kidney Injury ,Middle Aged ,medicine.disease ,Intensive care unit ,female genital diseases and pregnancy complications ,Intensive Care Units ,Wounds and Injuries ,General Earth and Planetary Sciences ,Female ,business ,Kidney disease - Abstract
Previous studies have reported the prevalence and risk factors of acute kidney injury (AKI) in relatively young trauma patients. The aims of this study were to identify the prevalence and risk factors of AKI among older Japanese trauma patients.We conducted a prospective observational study in the 8-bed intensive care unit (ICU) of a Japanese tertiary-care hospital. Participants comprised trauma patients aged 18 years or older admitted to the ICU. Our primary outcome was the incidence of AKI within 10days of admission, according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria.Among 333 patients, 66 (19.8%) developed AKI (Stage 1, n=54; Stages 2, n=5; and Stage 3, n=7). Multivariate logistic regression analysis revealed that the incidence of AKI was associated with increased age (odds ratio (OR), 1.38; 95% confidence interval (CI), 1.15-1.65), male sex (OR, 2.06; 95%CI, 1.04-4.07), greater amount of red blood cell transfusions (OR, 1.61; 95%CI, 1.04-1.17), and presence of underlying chronic kidney disease (CKD) (OR, 3.97; 95%CI, 1.78-8.83). Length of stay in the ICU was significantly longer in patients with AKI (6days) than in those without (3days; p0.001). Patients ≥65 years old were more likely to develop AKI (26.2% vs 11.6%; p0.001). No significant differences in ICU stay (median, 4 vs 4days; p=0.70), hospital stay (median, 24 vs 21days; p=0.45), or 28-day mortality (2.1% vs 1.4%; p=0.19) were evident between age groups.Approximately 20% of trauma patients developed AKI, and the elderly were more likely to develop AKI. Older age, male, greater units of red blood cell transfusions, and underlying CKD were associated with incidence of AKI.
- Published
- 2017