Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care (ANZIC) Research Centre, Monash University, Melbourne, VIC, Australia.
Ren Fail. 2010;32(9):1060-5. doi: 10.3109/0886022X.2010.510234.
There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with risk factors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize renal function. The incidence of AKI was 9.2% (19/207). Patients who developed AKI were older, had higher severity of illness scores, and a lower GCS. Overall 42.1% of these patients died in hospital compared with 18.1% in patients without AKI. In univariable linear regression analysis, age, severity of illness, and admitting hospital were associated with AKI. After multivariable logistic regression, the occurrence of AKI was associated with age (p < 0.001) and higher APACHE III scores (p = 0.016). AKI is relatively common even in patients with TBI. Its association with age and APACHE III scores helps identify patients at higher risk of AKI.
外伤性脑损伤（TBI）患者发生急性肾损伤（AKI）的信息有限，尽管 AKI 可能导致发病率和死亡率增加。我们研究了中重度 TBI 患者中 AKI 的发生率，以及 AKI 与这些患者的危险因素和结局的关系。我们研究了 2008 年 1 月 1 日至 12 月 31 日期间在澳大利亚维多利亚州的两家指定创伤医院收治的所有 16 岁以上的 TBI 患者。如果患者有头部创伤且格拉斯哥昏迷评分（GCS）<13，则纳入研究。从医院创伤登记处、ICU 和病理数据库中前瞻性收集的数据进行回顾性分析。使用风险损伤衰竭丧失终点（RIFLE）标准对肾功能进行分类。AKI 的发生率为 9.2%（19/207）。发生 AKI 的患者年龄更大，疾病严重程度评分更高，GCS 更低。这些患者的总死亡率为 42.1%，而无 AKI 的患者死亡率为 18.1%。在单变量线性回归分析中，年龄、疾病严重程度和入院医院与 AKI 相关。在多变量逻辑回归后，AKI 的发生与年龄（p<0.001）和更高的急性生理和慢性健康评估 III 评分（APACHE III）（p=0.016）相关。AKI 在 TBI 患者中也比较常见。其与年龄和 APACHE III 评分的相关性有助于识别 AKI 风险较高的患者。
