Acute posttraumatic renal failure: a multicenter perspective
| Autor: | R. Mackersie, B. F A Moore, J. Landercasper, Gregory J. Jurkovich, Edmund J. Rutherford, Sue M. Bass, Karl A. Illig, David B. Hoyt, E. E. Moore, S. R. Shackford, K. F. O'Malley, John A. Morris, P A Mucha, M. Rhodes, J. D. Schmoker, S. E. Ross, D. V. Feliciano, Wilcox Tr, Larry M. Gentilello, T. H. Cogbill |
|---|---|
| Předmět: |
Adult
Male Resuscitation medicine.medical_specialty medicine.medical_treatment Critical Care and Intensive Care Medicine Infections Injury Severity Score Renal Dialysis Internal medicine Medicine Humans Dialysis Cause of death Retrospective Studies business.industry Mortality rate Trauma center Acute kidney injury Acute Kidney Injury Middle Aged medicine.disease Surgery Wounds and Injuries Female Hemodialysis business |
| Zdroj: | Europe PubMed Central |
| Popis: | UNLABELLED Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098%) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70% increase in mortality over those without pre-existing conditions (p less than 0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82%). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18%) were discharged with renal insufficiency, three (9%) were discharged on dialysis, 23 (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant evidence of renal insufficiency. CONCLUSION Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57%). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|