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Identification of Risk Factors for Acute Kidney Injury from Intravenous Ketorolac in Geriatric Trauma Patients

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Abstract

Background

Ketorolac is an effective analgesic but the potential for acute kidney injury (AKI) is concerning, particularly in geriatric “G-60 trauma” patients. The objectives of this study are to report the incidence of AKI in patients who receive ketorolac, identify risk factors for AKI, and develop a risk factor-guided algorithm for safe utilization.

Methods

This retrospective cohort study included trauma patients age 60 years and older who received intravenous ketorolac. The primary endpoint was the incidence of AKI.

Results

Among 316 patients evaluated, the incidence of AKI was 2.5%. Patients with AKI received more nephrotoxins, had more comorbidities, and higher use of loop diuretics or vasopressors. Loop diuretic therapy and number of comorbidities were independent predictors of AKI.

Conclusions

Risk for AKI with ketorolac was low, being more prevalent with comorbidities or receipt of loop diuretics.

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Funding

No funding was provided for this study.

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Authors and Affiliations

  1. Department of Pharmacy, Mayo Clinic Health System, 700 West Avenue South, La Crosse, WI, 54601, USA

    Scott T. Hall

  2. Trauma and Acute Care Surgery, HonorHealth John C. Lincoln Medical Center, 250 E Dunlap Ave, Phoenix, AZ, 85020, USA

    Alicia J. Mangram

  3. College of Pharmacy, Midwestern University, 19555 N 59th Avenue, Glendale, AZ, 85308, USA

    Jeffrey F. Barletta

Authors
  1. Scott T. Hall
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  2. Alicia J. Mangram
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  3. Jeffrey F. Barletta
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Corresponding author

Correspondence to Scott T. Hall.

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Conflicts of interest

Jeffrey Barletta serves as a consultant for Wolters Kluwer. Scott Hall and Alicia Mangram have no conflicts of interest to disclose.

Ethics approval

This study received IRB approval prior to initiation.

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Hall, S.T., Mangram, A.J. & Barletta, J.F. Identification of Risk Factors for Acute Kidney Injury from Intravenous Ketorolac in Geriatric Trauma Patients. World J Surg 46, 98–103 (2022). https://doi.org/10.1007/s00268-021-06320-z

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  • DOI: https://doi.org/10.1007/s00268-021-06320-z

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