Acute Kidney Injury in Polytrauma Patients in Intensive Care Unit: A Prospective Observational Study
Mohammed Ismael Abd Elfattah Elsaaedy, Hanaa Mohamed Abdullah El Gendy, Gam al Eldin Adel Abd El Hameed, Mahmoud Abdelrahman Seifelnasr Ebrahim- General Medicine
Abstract
Background
Acute Kidney Injury (AKI) is a common complication of severe trauma patients and is associated with increased morbidity and mortality. Injury Severity Score (ISS) > 15 represents approximately 10% of all trauma patients in intensive care unit (ICU). The primary outcome of the study was to correlate between the AKI by using RIFLE criteria and the trauma severity by using ISS. While; the secondary outcomes were; identifying the incidence of AKI in polytrauma patients, the length of ICU and hospital stay and 28 days mortality.
Methods
This is a prospective observational study which was conducted during the period from May 2020 to September 2020. It Included 60 cases of polytrauma patients who have ISS>15, at Ain shams university hospitals, their ages ranged from 18-70 years. All patients’ data were recorded for: Injury Severity Score (ISS). RIFLE criteria. Length of ICU and hospital stay. 28 days mortality.
Results
There was no correlation between the incidence of AKI and the severity of the trauma by using ISS. Incidence of AKI the percentage was (45 %) among all the studied cases. According to RIFLE criteria, within this population, patients were classified as (21.7%) of the patients in the Risk stage; (18.3%) of the patients in Injury stage, and (5%) of the patients in Failure stage. There was statistically significant difference between AKI and No AKI regarding risk factors, percentages of sepsis, rhabdomyolysis, drugs, abdominal trauma and hypovolemic shock were higher in AKI patients than No AKI patients. There was no statistically significant difference between AKI patients and No AKI patients regarding mechanical ventilation, ICU stay, Hospital stay and 28 d Mortality.
Conclusion
The incidence of acute kidney injury in polytrauma patients in the intensive care unit was high and the overall mortality of our patients was as high as that reported in other studies. A better comprehension of risk factors associated with trauma-associated AKI is important, such as rhabdomyolysis, sepsis, abdominal trauma (compartment) and hypovolemic shock.