Acute Crit Care.  2023 May;38(2):217-225. 10.4266/acc.2023.00388.

Epidemiology and outcome of an acute kidney injuries in the polytrauma victims admitted at the apex trauma center in Dubai

• Wankhade BS
• Alrais ZF
• Alrais GZ
• Hadi AMA
• Naidu GAK
• Abbas MS
• Kheir ATYA
• Hadad H
• Sharma S
• Sait M

• KMID: 2543641
• DOI: http://doi.org/10.4266/acc.2023.00388

Abstract

Background
Polytrauma from road accidents is a common cause of hospital admissions and deaths, frequently leading to acute kidney injury (AKI) and impacting patient outcomes. Methods: This retrospective, single-center study included polytrauma victims with an Injury Severity Score (ISS) >25 at a tertiary healthcare center in Dubai. Results: 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). Conclusions: 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.

Keyword

acute kidney injury; injury severity score; multiple trauma; rhabdomyolysis; renal replacement therapy; rhabdomyolysis

Figure

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  Figure 1. Consort flow diagram. AKI: acute kidney injury; ISS: Injury Severity Score.

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  Figure 2. Showing logistic regression model illustrating relation between acute kidney injury (AKI) and Injury Severity Score (ISS).

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