Incidence and Burden of Acute Kidney Injury among Traumatic Brain-Injury Patients

Abstract

Ruoran Wang,1 Jing Zhang,1 Jing Xu,2 Min He,2 Jianguo Xu1 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 2Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of ChinaCorrespondence: Min HeDepartment of Critical Care Medicine, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, People’s Republic of ChinaEmail [email protected] XuDepartment of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, People’s Republic of ChinaEmail [email protected]: Acute kidney injury (AKI) has been occurs commonly in the clinical management of traumatic brain injury (TBI) patients and is correlated with outcomes in these patients. We designed this study to investigate the incidence, duration, stage, and burden of AKI among these patients.Methods: A total of 419 TBI inpatients at our hospital were included in the study. We calculated the AKI burden, reflecting both stage and duration, and then analyzed associations among AKI occurrence, highest AKI stage, AKI duration, AKI burden, and outcomes with logistic regression analysis.Results: Incidence of AKI among TBI patients was 19.8%. These patients’ AKIs occurred mainly on the first day from admission (10.74%), and mostly developed stage 1 AKI (9.79%). Modes of AKI duration and burden in those with AKI were both 1. Multivariate logistic regression showed AKI occurrence (OR 3.792, p=0.004) and the highest AKI stage (OR 3.122, p< 0.001) was significantly associated with mortality. Neither AKI duration (OR 1.083, p=0.206) nor AKI burden (OR 1.062, p=0.171) were associated with mortality. Incorporating AKI occurrence or highest AKI stage did not improve the predictive value of the constructed prognostic model.Conclusion: The high-incidence period of AKI in TBI patients was the first 3 days after admission. AKI occurrence and highest AKI stage were associated with mortality, while AKI duration and AKI burden were not associated with mortality.Keywords: acute kidney-injury duration, acute kidney-injury burden, traumatic brain injury, mortality

Keywords

• acute kidney injury duration
• acute kidney injury burden
• traumatic brain injury
• mortality