Acute kidney injury in trauma patients admitted to the ICU: a systematic review and meta-analysis
| Autor: | Torsten Eken, Marie Susanna Isachsen, Sigrid Beitland, Christine Kooy Tveiten, Kjetil Gundro Brurberg, Kjetil Sunde, Signe Søvik, Kine Marie Byman Nordhuus |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment wounds and injuries Critical Care and Intensive Care Medicine urologic and male genital diseases law.invention 03 medical and health sciences 0302 clinical medicine systematic review law Anesthesiology Internal medicine medicine critical illness risk factors Rifle Renal replacement therapy VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nefrologi urologi: 772 business.industry Glasgow Coma Scale Acute kidney injury 030208 emergency & critical care medicine medicine.disease mortality Intensive care unit female genital diseases and pregnancy complications acute kidney injury 030228 respiratory system Meta-analysis Injury Severity Score business |
| Zdroj: | Intensive Care Medicine |
| ISSN: | 0342-4642 |
| Popis: | This is a post-peer-review, pre-copyedit version of an article published in Intensive Care Medicine. The final authenticated version is available online at: https://doi.org/10.1007/s00134-019-05535-y Purpose To perform a systematic review and meta-analysis of acute kidney injury (AKI) in trauma patients admitted to the intensive care unit (ICU). Methods We conducted a systematic literature search of studies on AKI according to RIFLE, AKIN, or KDIGO criteria in trauma patients admitted to the ICU (PROSPERO CRD42017060420). We searched PubMed, Cochrane Database of Systematic Reviews, UpToDate, and NICE through 3 December 2018. Data were collected on incidence of AKI, risk factors, renal replacement therapy (RRT), renal recovery, length of stay (LOS), and mortality. Pooled analyses with random effects models yielded mean differences, OR, and RR, with 95% CI. Results Twenty-four observational studies comprising 25,182 patients were included. Study quality (Newcastle–Ottawa scale) was moderate. Study heterogeneity was substantial. Incidence of post-traumatic AKI in the ICU was 24% (20–29), of which 13% (10–16) mild, 5% (3–7) moderate, and 4% (3–6) severe AKI. Risk factors for AKI were African American descent, high age, chronic hypertension, diabetes mellitus, high Injury Severity Score, abdominal injury, shock, low Glasgow Coma Scale (GCS) score, high APACHE II score, and sepsis. AKI patients had 6.0 (4.0–7.9) days longer ICU LOS and increased risk of death [RR 3.4 (2.1–5.7)] compared to non-AKI patients. In patients with AKI, RRT was used in 10% (6–15). Renal recovery occurred in 96% (78–100) of patients. Conclusions AKI occurred in 24% of trauma patients admitted to the ICU, with an RRT use among these of 10%. Presence of AKI was associated with increased LOS and mortality, but renal recovery in AKI survivors was good. |
| Databáze: | OpenAIRE |
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