Wankhade Bhushan Sudhakar, Alrais Zeyad Faoor, Alrais Ghaya Zeyad, Hadi Ammar Mohamed Abdel, Naidu Gopala Arun Kumar, Abbas Mohammed Shahid, Kheir Ahmed Tarek Youssef Aboul, Hadad Hasan, Sharma Sundareswaran, Sait Mohammad
Department of Surgical Intensive Care Medicine, Rashid Hospital, Oud Metha, Dubai, UAE.
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.
Acute Crit Care. 2023 May;38(2):217-225. doi: 10.4266/acc.2023.00388. Epub 2023 May 25.
Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes.
This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai.
The incidence of AKI in polytrauma victims is 30.5%, associated with higher Carlson comorbidity index (P=0.021) and ISS (P=0.001). Logistic regression shows a significant relationship between ISS and AKI (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.150-1.233; P<0.05). The main causes of trauma-induced AKI are hemorrhagic shock (P=0.001), need for massive transfusion (P<0.001), rhabdomyolysis (P=0.001), and abdominal compartment syndrome (ACS; P<0.001). On multivariate logistic regression AKI can be predicated by higher ISS (OR, 1.08; 95% CI, 1.00-1.17; P=0.05) and low mixed venous oxygen saturation (OR, 1.13; 95% CI, 1.05-1.22; P<0.001). The development of AKI after polytrauma increases length of stay (LOS)-hospital (P=0.006), LOS-intensive care unit (ICU; P=0.003), need for mechanical ventilation (MV) (P<0.001), ventilator days (P=0.001), and mortality (P<0.001).
After polytrauma, the occurrence of AKI leads to prolonged hospital and ICU stays, increased need for mechanical ventilation, more ventilator days, and a higher mortality rate. AKI could significantly impact their prognosis.
道路交通事故所致的多发伤是医院收治患者及导致死亡的常见原因，常引发急性肾损伤（AKI）并影响患者预后。
这项回顾性单中心研究纳入了迪拜一家三级医疗中心损伤严重程度评分（ISS）>25的多发伤患者。
多发伤患者中AKI的发生率为30.5%，与较高的卡尔森合并症指数（P = 0.021）和ISS（P = 0.001）相关。逻辑回归显示ISS与AKI之间存在显著关联（比值比[OR]，1.191；95%置信区间[CI]，1.150 - 1.233；P < 0.05）。创伤性AKI的主要原因是失血性休克（P = 0.001）、大量输血需求（P < 0.001）、横纹肌溶解（P = 0.001）和腹腔间隔室综合征（ACS；P < 0.001）。多因素逻辑回归显示，较高的ISS（OR，1.08；95% CI：1.00 - 1.17；P = 0.05）和低混合静脉血氧饱和度（OR，1.13；95% CI：1.05 - 1.22；P < 0.001）可预测AKI。多发伤后发生AKI会增加住院时间（LOS）（P = 0.006）、重症监护病房（ICU）住院时间（P = 0.003）、机械通气（MV）需求（P < 0.001）、呼吸机使用天数（P = 0.001）和死亡率（P < 0.001）。
多发伤后，AKI的发生会导致住院和ICU住院时间延长，机械通气需求增加，呼吸机使用天数增多，死亡率升高。AKI会显著影响患者预后。
