de Abreu Krasnalhia Lívia S, Silva Júnior Geraldo B, Barreto Adller G C, Melo Fernanda M, Oliveira Bárbara B, Mota Rosa M S, Rocha Natália A, Silva Sônia L, Araújo Sônia M H A, Daher Elizabeth F
Division of Nephrology, Department of Internal Medicine, School of Medicine, Walter Cantídio University Hospital, Ceará, Brazil.
Indian J Crit Care Med. 2010 Jul;14(3):121-8. doi: 10.4103/0972-5229.74170.
Acute kidney injury (AKI) is an uncommon but serious complication after trauma. The objective of this study was to evaluate the prevalence, clinical characteristics and outcome of AKI after trauma.
This was a retrospective study performed from January 2006 to January 2008 in an emergency specialized hospital in Fortaleza city, northeast of Brazil. All patients with AKI admitted in the study period were included. Prevalence of AKI, clinical characteristics and outcome were investigated.
Of the 129 patients admitted to the intensive care unit (ICU), 52 had AKI. The mean age was 30.1 ± 19.2 years, and 79.8% were males. The main causes of AKI were sepsis in 27 cases (52%) and hypotension in 18 (34%). Oliguria was observed in 33 cases (63%). Dialysis was required for 19 patients (36.5%). Independent risk factors associated with AKI were abdominal trauma [odds ratio (OR) = 3.66, P = 0.027] and use of furosemide (OR = 4.10, P = 0.026). Patients were classified according to RIFLE criteria as Risk in 12 cases (23%), Injury in 13 (25%), Failure in 24 (46%), Loss in 1 (2%) and End-stage in 2 (4%). Overall in-hospital mortality was 95.3%. The main cause of death was sepsis (24%). Mortality was 100% among patients with AKI.
AKI is a fatal complication after trauma, which presented with a high mortality in the studied population. A better comprehension of factors associated with death in trauma-associated AKI is important, and more effective measures of prevention and treatment of AKI in this population are urgently needed.
急性肾损伤（AKI）是创伤后一种不常见但严重的并发症。本研究的目的是评估创伤后AKI的患病率、临床特征及预后。
这是一项于2006年1月至2008年1月在巴西东北部福塔雷萨市一家急诊专科医院进行的回顾性研究。纳入研究期间收治的所有AKI患者。对AKI的患病率、临床特征及预后进行调查。
在129例入住重症监护病房（ICU）的患者中，52例发生AKI。平均年龄为30.1±19.2岁，79.8%为男性。AKI的主要病因是27例（52%）脓毒症和18例（34%）低血压。33例（63%）出现少尿。19例患者（36.5%）需要透析。与AKI相关的独立危险因素是腹部创伤[比值比（OR）=3.66，P=0.027]和使用呋塞米（OR=4.10，P=0.026）。根据RIFLE标准，患者分为风险期12例（23%）、损伤期13例（25%）、衰竭期24例（46%）、丧失期1例（2%）和终末期2例（4%）。总体院内死亡率为95.3%。主要死亡原因是脓毒症（24%）。AKI患者的死亡率为100%。
AKI是创伤后一种致命的并发症，在所研究人群中死亡率很高。更好地理解创伤相关性AKI中与死亡相关的因素很重要，并且迫切需要针对该人群更有效的AKI预防和治疗措施。
