Intensive Care Medicine

, Volume 24, Issue 8, pp 808–814

Risk factors for acute renal failure in trauma patients

  • G. Vivino
  • M. Antonelli
  • M. L. Moro
  • F. Cottini
  • G. Conti
  • M. Bufi
  • F. Cannata
  • A. Gasparetto
Original

Abstract

Objective

To elucidate the risk factors for the development of acute renal failure (ARF) in severe trauma.

Design

Prospective observational study.

Setting

A general intensive care unit (ICU) of a university hospital.

Patients

A cohort of 153 consecutive trauma patients admitted to the ICU over a period of 30 months.

Results

Forty-eight (31 %) patients developed ARF. They were older than the 105 patients without ARF (p=0.002), had a higher Injury Severity Score (ISS) (p>0.001), higher mortality (p>0.001), a more compromised neurological condition (p=0.007), and their arterial pressure at study entry was lower (p=0.0015). In the univariate analysis, the risk of ARF increased by age, ISS>17, the presence of hemoperitoneum, shock, hypotension, or bone fractures, rhabdomyolysis with creatine Phosphokinase (CPK)>10000 IU/1, presence of acute lung injury requiring mechanical ventilation, and Glasgow Coma Score>10. Sepsis and use of nephrotoxic agents were not associated with an increased risk of ARF. In the logistic model, the need for mechanical ventilation with a positive end-expiratory pressure>6 cm H2O, rhabdomyolysis with CPK>10000 IU/1, and hemoperitoneum were the three conditions most strongly associated with ARF.

Conclusions

The identified risk factors for post-traumatic acute renal failure may help the provision of future strategies.

Key words

Acute renal failure Trauma Rhabdomiolysis Mechanical ventilation Hemoperitoneum 

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Copyright information

© Springer-Verlag 1998

Authors and Affiliations

  • G. Vivino
    • 1
  • M. Antonelli
    • 1
  • M. L. Moro
    • 2
  • F. Cottini
    • 1
  • G. Conti
    • 1
  • M. Bufi
    • 1
  • F. Cannata
    • 1
  • A. Gasparetto
    • 1
  1. 1.Istituto di Anestesiologia e RianimazioneUniversité La Sapienza, Policlinico Umberto IRomeItaly
  2. 2.Laboratorio di Epidemiologia e BiostatisticaIstituto Superiore di SanitàRomeItaly

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