Faculty Collaboration Database

African American race, obesity, and blood product transfusion are risk factors for acute kidney injury in critically ill trauma patients. J Crit Care 2012 Oct;27(5):496-504

Date

05/18/2012

Pubmed ID

22591570

Pubmed Central ID

PMC3472045

DOI

10.1016/j.jcrc.2012.02.002

Scopus ID

2-s2.0-84867335081 (requires institutional sign-in at Scopus site)   84 Citations

Abstract

PURPOSE: Acute kidney injury (AKI) is a common source of morbidity after trauma. We sought to determine novel risk factors for AKI, by Acute Kidney Injury Network (AKIN) criteria, in critically ill trauma patients.

MATERIALS AND METHODS: A prospective cohort of 400 patients admitted to the intensive care unit of a level 1 trauma center was followed for the development of AKI over 5 days.

RESULTS: Acute kidney injury developed in 147 (36.8%) of 400 patients. In multivariable regression analysis, independent risk factors for AKI included African American race (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.08-3.18; P = .024), body mass index of 30 kg/m(2) or greater (OR, 4.72 versus normal body mass index; 95% CI, 2.59-8.61; P < .001), diabetes mellitus (OR, 3.26; 95% CI, 1.30-8.20; P = .012), abdominal Abbreviated Injury Scale score of 4 or more (OR, 3.78; 95% CI, 1.79-7.96; P < .001), and unmatched packed red blood cells administered during resuscitation (OR, 1.13 per unit; 95% CI, 1.04-1.23; P = .004). Acute Kidney Injury Network stages 1, 2, and 3 were associated with hospital mortality rates of 9.8%, 13.7%, and 30.4%, respectively, compared with 3.8% for those without AKI (P < .001).

CONCLUSIONS: Acute kidney injury in critically ill trauma patients is associated with substantial mortality. The findings of African American race, obesity, and blood product administration as independent risk factors for AKI deserve further study to elucidate underlying mechanisms.

Author List

Shashaty MG, Meyer NJ, Localio AR, Gallop R, Bellamy SL, Holena DN, Lanken PN, Kaplan S, Yarar D, Kawut SM, Feldman HI, Christie JD

Author

Daniel N. Holena MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abbreviated Injury Scale
Acute Kidney Injury
Adolescent
Adult
Aged
Aged, 80 and over
Blood Transfusion
Body Mass Index
Comorbidity
Critical Illness
Diabetes Mellitus
Female
Humans
Intensive Care Units
Male
Middle Aged
Obesity
Prospective Studies
Risk Factors
Trauma Centers
Wounds and Injuries
Young Adult