Abstract text (incl. references and figure legends)
Background: The incidence and risk factors of acute kidney injury (AKI) in young trauma population is not well described. We aimed to evaluate the epidemiology, clinical characteristics, and outcome of AKI after trauma.
Methods: A retrospective study of all adult trauma patients admitted at a level 1 trauma centre between 2011 and 2021 was conducted. The diagnosis of AKI was based on the Kidney Disease Improving Global Outcomes (KDIGO) criteria.
Results: A total of 17,341 trauma patients were evaluated, of which 140 developed AKI (0.8%). Patients with AKI were older (40±20 vs 32±16 years), had more comorbidities, and higher Injury Severity Score (ISS) and in-hospital mortality (65% vs 3.2%) than non-AKI patients. Direct trauma to the kidney was reported in only 9 (6.4%) cases in the AKI group. Moreover, non-survivors AKI patients had higher ISS, more likely to have hypotension, elevated serum lactate, positive troponin, and lower platelet-to-lymphocyte ratio. Multiple logistic regression analyses showed that age, ISS, acute respiratory distress syndrome , blood transfusion, diabetes mellitus, and on-admission Glasgow coma scale and shock index were predictors of AKI in trauma patients, whereas ISS (OR =1.05; 95% CI: 1.003-1.100; P=0.03), serum lactate (OR =1.25; 95% CI: 1.019-1.533; P=0.03), and hypotension (OR =3.22; 95% CI: 1.044-9.945; P=0.04) were independent predictors of mortality in patients with AKI. Cox-regression analysis showed that none of the AKI stages has impact on mortality after adjustment for age, hypotension and ISS.
Conclusion: AKI in young trauma patients is uncommon and associated with prolonged hospital course and higher mortality. This study identified factors that independently predicted the development of AKI and its outcome in trauma patients.
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