Randox Laboratories Ltd, 55 Diamond Road, Crumlin, County Antrim, BT29 4QY, Northern Ireland, UK.
Department of Cardiac Anaesthesia, Royal Victoria Hospital, Belfast Health and Social Care Trust, 274 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK.
Sci Rep. 2020 Nov 17;10(1):20005. doi: 10.1038/s41598-020-76929-y.
Acute kidney injury (AKI) after major trauma is associated with increased mortality. The aim of this study was to assess if measurement of blood biomarkers in combination with clinical characteristics could be used to develop a tool to assist clinicians in identifying which orthopaedic trauma patients are at risk of AKI. This is a prospective study of 237 orthopaedic trauma patients who were consecutively scheduled for open reduction and internal fixation of their fracture between May 2012 and August 2013. Clinical characteristics were recorded, and 28 biomarkers were analysed in patient blood samples. Post operatively a combination of H-FABP, sTNFR1 and MK had the highest predictive ability to identify patients at risk of developing AKI (AUROC 0.885). Three clinical characteristics; age, dementia and hypertension were identified in the orthopaedic trauma patients as potential risks for the development of AKI. Combining biomarker data with clinical characteristics allowed us to develop a proactive AKI clinical tool, which grouped patients into four risk categories that were associated with a clinical management regime that impacted patient care, management, length of hospital stay, and efficient use of hospital resources.
严重创伤后急性肾损伤（AKI）与死亡率增加有关。本研究旨在评估血液生物标志物与临床特征相结合是否可用于开发一种工具，以帮助临床医生识别哪些骨科创伤患者有发生 AKI 的风险。这是一项前瞻性研究，纳入了 237 例骨科创伤患者，这些患者在 2012 年 5 月至 2013 年 8 月期间连续接受骨折切开复位内固定治疗。记录了临床特征，并分析了患者血液样本中的 28 种生物标志物。术后，H-FABP、sTNFR1 和 MK 的组合具有最高的预测能力来识别发生 AKI 的风险患者（AUROC 0.885）。在骨科创伤患者中，年龄、痴呆和高血压这 3 种临床特征被确定为 AKI 发展的潜在风险。将生物标志物数据与临床特征相结合，使我们能够开发出一种主动 AKI 临床工具，该工具将患者分为四个风险类别，与影响患者护理、管理、住院时间和医院资源有效利用的临床管理方案相关。
