Putra O N, Saputro I D, Diana D
Department of Clinical Pharmacy, Study Program of Pharmacy, Hang Tuah University, Surabaya, Indonesia.
Faculty of Medicine, Airlangga University - General Hospital of Dr. Soetomo, Surabaya, Indonesia.
Ann Burns Fire Disasters. 2021 Sep 30;34(3):252-258.
Acute kidney injury is one of the severe complications after burns. The purpose of this study was to identify prevalence, risk factors to the development of acute kidney injury (AKI) in burn patients and mortality, using RIFLE classification: risk (R), injury (I), failure (F), loss (L), and end-stage kidney disease (E). This 3-year retrospective study was conducted in burn patients admitted to the Dr. Soetomo Hospital Burn Center between January 2018 and September 2020. Burn patients aged >18 years old and diagnosed with acute kidney injury during hospitalization were enrolled in this study. Factors influencing AKI and its mortality were assessed using bivariate and multivariate logistic regression analysis. Eighty-nine burn patients were available for analysis, and 18 (20%) of them developed AKI according to the RIFLE classification: risk in 6 (33%), injury in 7 (39%) and failure in 5 (28%). Patients with AKI had a significantly higher age and % of TBSA than those without AKI (p-value <0.05). Age more than 60 years old was significantly associated as a risk factor to develop AKI (OR=25.553, p value=0.014). The mortality rate of patients with AKI was 83% (15 deaths from 18 patients), with the overall mortality of patients 16.8%. Chi-square analysis indicated inhalation injury, % of TBSA, and age as risk factors for mortality (p-value < 0.05). The conclusion of our study was that the incidence of AKI in burn patients was relatively high. Older age as a risk factor to develop AKI and inhalation injury, TBSA, and age were associated with mortality.
急性肾损伤是烧伤后严重的并发症之一。本研究的目的是使用RIFLE分类法（风险（R）、损伤（I）、衰竭（F）、丧失（L）和终末期肾病（E））确定烧伤患者急性肾损伤（AKI）的患病率、发生AKI的危险因素及死亡率。这项为期3年的回顾性研究对2018年1月至2020年9月期间入住苏托莫医生医院烧伤中心的烧伤患者进行。年龄>18岁且住院期间诊断为急性肾损伤的烧伤患者纳入本研究。使用双变量和多变量逻辑回归分析评估影响AKI及其死亡率的因素。89例烧伤患者可供分析，其中18例（20%）根据RIFLE分类法发生AKI：6例（33%）为风险期，7例（39%）为损伤期，5例（28%）为衰竭期。与未发生AKI的患者相比，发生AKI的患者年龄和烧伤总面积百分比显著更高（p值<0.05）。60岁以上的年龄是发生AKI的显著相关危险因素（OR=25.553，p值=0.014）。AKI患者的死亡率为83%（18例患者中有15例死亡），患者的总死亡率为16.8%。卡方分析表明吸入性损伤、烧伤总面积百分比和年龄是死亡的危险因素（p值<0.05）。我们研究的结论是烧伤患者中AKI的发生率相对较高。年龄较大是发生AKI的危险因素，吸入性损伤、烧伤总面积和年龄与死亡率相关。
