ACUTE KIDNEY INJURY AMONG TRAUMA PATIENTS SEEN AT THE NATIONAL TRAUMA CENTER ABUJA: RISK FACTORS AND SHORT-TERM OUTCOMES.

Abstract

BACKGROUND: Patients who have experienced trauma may develop acute kidney injury (AKI), which is associated with greater morbidity and mortality rates.     

OBJECTIVES: The aim was to identify incidence, risk factors and short-term outcome of AKI in trauma patients admitted to the National Trauma Centre in National Hospital Abuja.

METHODS: This was a cohort study of 239 adult trauma patients who underwent screening and classification for AKI based on the criteria established by the Kidney Disease Improving Global Outcome guidelines. Those that developed AKI were compared with those without AKI. Outcomes were observed up to Day 30 of the study or earlier if discharged or died.

RESULTS: Among 20.9% patients who developed AKI, risk factors observed were older age (adjusted OR 1.04, 95% CI 1.00-1.09, P= 0.04), admission to intensive care unit (adjusted OR 4.12, 95% CI 1.1–15.35, P=0.04), abdominal trauma (adjusted OR 22.41, 95% CI 6.66-75.36, P <0.0001), multiple injuries (adjusted OR 3.34, 95% CI 1.33-8.4, P= 0.01), and length of hospital stay (adjusted OR 1.04, 95% CI 1.0- 1.08, P= 0.04).

Majority had rapid reversal of AKI, 8% had Acute Kidney Disease and 16% had persistent AKI. In-hospital mortality was higher with AKI (20% versus 0.5%). Twelve percent of AKI patients had intermittent hemodialysis and mortality was higher in the RRT vs conservative group (83.3% vs 11.4%, p=0.001).

CONCLUSION: Increased vigilance and prevention of AKI is warranted in managing trauma patients, given the increased risk.

KEY WORDS: Acute kidney injury, trauma patients, KDIGO criteria, risk factors, short-term outcome.