Soni Kapil Dev, Singh Abhishek, Tyagi Abhay, Singh Yudhyavir, Aggarwal Richa, Trikha Anjan
Department of Critical and Intensive Care, JPN Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Indian J Crit Care Med. 2023 Jan;27(1):22-25. doi: 10.5005/jp-journals-10071-24380.
Acute kidney injury (AKI) following severe trauma is common. However, the requirement of renal replacement therapy (RRT) in these patients is rare and is associated with high morbidity and mortality. The primary objective of this study was to identify odds of risk factors, in particular, hypotension at presentation, for the requirement of RRT in patients with AKI following trauma.
We performed a case-control study involving patients who were admitted to the intensive care unit (ICU) at a level I trauma center for at least 24 hours. The primary outcome measure was a study of the odds of risk factors associated with the requirement of RRT in such patients. Univariate comparisons and multiple logistic regression analyses were done to identify other risk factors.
The presence of crush injury, sepsis, and elevated serum creatinine (sCr) on arrival were identified to be independent risk factors for RRT requirement. Hypotension and exposure to radiocontrast or nephrotoxic antimicrobials were not found to be associated with the need for RRT. Acute kidney injury requiring RRT was associated with significantly increased ICU length of stay (15 days vs 5 days; < 0.001) and higher mortality (83% vs 35%; < 0.001).
The presence of crush injury, sepsis, and elevated sCr on presentation were identified to be independent risk factors while hypotension association was insignificant for AKI requiring RRT in our investigation.
Soni KD, Singh A, Tyagi A, Singh Y, Aggarwal R, Trikha A. Risk Factors and Outcomes of Post-traumatic Acute Kidney Injury Requiring Renal Replacement Therapy: A Case-Control Study. Indian J Crit Care Med 2023;27(1):22-25.
严重创伤后急性肾损伤（AKI）很常见。然而，这些患者需要肾脏替代治疗（RRT）的情况很少见，且与高发病率和死亡率相关。本研究的主要目的是确定创伤后发生AKI的患者需要RRT的危险因素的比值比，尤其是就诊时的低血压。
我们进行了一项病例对照研究，纳入在一级创伤中心重症监护病房（ICU）住院至少24小时的患者。主要结局指标是研究此类患者中与需要RRT相关的危险因素的比值比。进行单因素比较和多因素逻辑回归分析以确定其他危险因素。
发现挤压伤、脓毒症以及入院时血清肌酐（sCr）升高是需要RRT的独立危险因素。未发现低血压以及接触放射性造影剂或肾毒性抗菌药物与需要RRT有关。需要RRT的急性肾损伤与ICU住院时间显著延长（15天对5天；P<0.001）和更高的死亡率（83%对35%；P<0.001）相关。
在我们的研究中，发现挤压伤、脓毒症以及就诊时sCr升高是独立危险因素，而低血压与需要RRT的AKI的相关性不显著。
索尼KD，辛格A，蒂亚吉A，辛格Y，阿加瓦尔R，特里卡A。创伤后需要肾脏替代治疗的急性肾损伤的危险因素和结局：一项病例对照研究。《印度重症监护医学杂志》2023；27(1):22 - 25。
