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Emergency Radiology

, Volume 24, Issue 5, pp 541–546 | Cite as

Is measurement of renal function necessary for all trauma patients before iodinated contrast administration?

  • Haddon PantelEmail author
  • Kristian D. Stensland
  • Jeffrey Hashim
  • Michael Rosenblatt
Original Article
  • 280 Downloads

Abstract

Purpose

The purpose of this study was to identify factors at the time of presentation which could quickly exclude or identify renal dysfunction in blunt trauma patients, thus negating serum measurement of renal function prior to contrast-enhanced imaging and expediting care.

Methods

Patients, >18 years old, without renal failure, presenting after blunt trauma, with serum creatinine measured at presentation, were retrospectively studied at a single center. Variables recorded at presentation including vitals, mechanism, and past medical history were analyzed using multivariate regression analysis to identify independent predictors of abnormal renal function.

Results

From 2009 to 2015, a total of 1099 patients met the inclusion criteria. Of those, 75 (6.8%) had renal dysfunction at presentation. Patients with renal dysfunction had a mean age of 74.3 (SD 15.5) years old, and 57.3% were male. Multivariate analysis identified independent predictors of renal dysfunction at presentation as age ≥ 61 (p < 0.001), hypotension (p = 0.02), and diabetes (p = 0.02). The presence of a single identified factor had an 85% sensitivity for renal dysfunction and a 98.5% negative predictive value.

Conclusions

Impaired renal function at presentation was infrequent in our trauma cohort. Trauma patients who were normotensive, under the age of 61, and without diabetes were unlikely to have impaired renal function at presentation. In the urgent setting of trauma, patients without these comorbidities are likely safe to forgo screening of renal function prior to contrast-enhanced imaging.

Keywords

Trauma Contrast CIN Screening 

Notes

Compliance with ethical standards

All work was approved by the Institutional Review Board (IRB). Exemption from subject informed consent was approved by the IRB due to all information being retrospective, no individual patient identifying information being obtained, no identifying information being part of any of the work or publication, and no contact made with any subjects.

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

This was not funded by any grants.

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Copyright information

© American Society of Emergency Radiology 2017

Authors and Affiliations

  • Haddon Pantel
    • 1
    Email author
  • Kristian D. Stensland
    • 2
  • Jeffrey Hashim
    • 3
  • Michael Rosenblatt
    • 1
  1. 1.Department of General SurgeryLahey Hospital and Medical CenterBurlingtonUSA
  2. 2.Department of UrologyLahey Hospital and Medical CenterBurlingtonUSA
  3. 3.Department of RadiologyLahey Hospital and Medical CenterBurlingtonUSA

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