Association of AKI with Adverse Outcomes in Burned Military Casualties
| Autor: | Casey L. Cotant, Molly A Tilley, James K. Aden, Evan M. Renz, Hana K. Kwan, Ian J. Stewart, Christopher Gisler, Kevin K. Chung, Jeffery McCorcle |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Epidemiology Burn Units Hospitals Military Critical Care and Intensive Care Medicine Logistic regression Risk Assessment Severity of Illness Index law.invention Young Adult Risk Factors law Internal medicine Severity of illness Odds Ratio Prevalence Humans Medicine Rifle Iraq War 2003-2011 Retrospective Studies Transplantation Afghan Campaign 2001 business.industry Incidence Mortality rate Age Factors Odds ratio Acute Kidney Injury Prognosis Intensive care unit United States Surgery Logistic Models Military Personnel Nephrology Creatinine Multivariate Analysis Injury Severity Score Female Burns business Total body surface area Biomarkers Burns Inhalation |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 7:199-206 |
| ISSN: | 1555-9041 |
| Popis: | Although associated with increased morbidity and mortality, AKI has not been systematically examined in military personnel injured from combat operations in Iraq and Afghanistan.Patients evacuated from Iraq and Afghanistan to a burn unit were examined. AKI was classified by the Acute Kidney Injury Network (AKIN) and Risk-Injury-Failure-Loss-End Stage (RIFLE) schemas. Age, sex, percentage of total body surface area burned (TBSA), percentage of full-thickness burn, inhalation injury, and injury severity score were recorded. Additional data that could be associated with poor outcomes were recorded for patients with TBSA ≥20%. Multivariate logistic regression analyses were performed to determine factors associated with morbidity and mortality.AKI prevalence rates by the RIFLE and AKIN criteria were 23.8% and 29.9%, respectively. After logistic regression, RIFLE categories of risk (odds ratio [OR], 15.34; 95% confidence interval [CI], 1.75-134; P=0.01), injury (OR, 46.28; 95% CI, 5.02-427; P0.001), and failure (OR, 126; 95% CI, 13.39-999; P0.001); AKIN-2 (OR, 23.70; 95% CI, 2.32-242; P=0.008); and AKIN-3 (OR, 130; 95% CI, 13.38-999; P0.001) were significantly associated with death. AKIN-3, injury, and failure remained significant in the subset of patients with ≥20% TBSA. There was also a strong interaction between TBSA and the stage of AKI with respect to ventilator and intensive care unit days.AKI is prevalent in military casualties with burn injury and is independently associated with morbidity and mortality after adjustment for factors associated with injury severity. |
| Databáze: | OpenAIRE |
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