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Subject Area

General Surgery

Article Type

Original Study

Abstract

Objective To define and determine acute kidney injury (AKI) based on the Kidney Disease Improving Global Outcome criteria in severe trauma patients, and to evaluate injury severity score (ISS) in the prediction of AKI and outcomes. Background Because of the great risk of AKI in severe trauma that may be life threatening especially if uncontrolled, early assessment of it reduces mortality of polytraumatized patients. Patients and methods This is a prospective study on 116 trauma patients, who were presented to the Emergency Department of Menoufia University Hospital from April 2019 to April 2020. ISS and the Acute Physiology and Chronic Health Evaluation scores were applied to all trauma patients. Results The overall incidence of AKI following trauma was 33.6%. There was no difference in patients' age, sex, and body weight between groups, whereas there was a significant difference in ISS, Glasgow coma scale, and presence of shock. In multivariate analysis, the independent risk factors associated with AKI after trauma included the ISS (odds ratio = 1.063, P < 0.05) and presence of shock (odds ratio = 0.958, P = 0.003). Renal replacement therapy was required for 11 (28.2%) patients in the AKI group. Hospital mortality rate was higher in the AKI group (23/39, 59%) than the non-AKI group (20/77, 26%; P = 0.001). Conclusion The development of AKI was associated with the severity of trauma, and AKI increased mortality rates.

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