Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury.
Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury.
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DOI：
10.1007/s12028-020-01183-z
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发表时间：
2021-10
影响因子：
3.5
通讯作者：
Krishnamoorthy V
中科院分区：
文献类型：
--
作者：
Luu D;Komisarow J;Mills BM;Vavilala MS;Laskowitz DT;Mathew J;James ML;Hernandez A;Sampson J;Fuller M;Ohnuma T;Raghunathan K;Privratsky J;Bartz R;Krishnamoorthy V
创伤性脑损伤（TBI）是美国发病率、死亡率和残疾的主要原因。虽然心肺功能障碍可能导致严重TBI后的不良结局，但对急性肾损伤（阿基）的影响了解甚少。我们研究了严重阿基与医院死亡率和严重TBI后的医疗保健利用之间的关系。我们使用2007-2014年的国家创伤数据库（NTDB）进行了一项回顾性队列研究。我们确定了一组患有孤立性重度TBI的成人患者，并描述了重度阿基的发生率，相当于急性肾损伤网络3期或更高疾病。我们使用多变量logistic回归模型研究了严重阿基与医院死亡率主要结局的相关性。在二次分析中，我们检查了重度阿基与透析导管放置、气管造口术和胃造口术使用以及住院时间的相关性。在研究期间，有37，851名患者经历了孤立的重度TBI。在这些患者中，787例（2.1%）发生重度（3期或以上）阿基。在多变量模型中，医院内严重阿基的发生与院内死亡率相关（OR 2.03，95% CI 1.64 - 2.52），需要气管造口术（OR 2.10，95% CI 1.52 - 2.89）、PEG管放置（OR 1.88，95% CI 1.45 - 2.45）和住院时间延长（p<0.001）。重度阿基的总体发生率相对较低（2.1%），但与死亡率增加和重度TBI后医疗保健利用增加的多个标志物相关。
Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the United States. While cardiopulmonary dysfunction can result in poor outcomes following severe TBI, the impact of acute kidney injury (AKI) is poorly understood. We examined the association between severe AKI with hospital mortality and healthcare utilization following isolate severe TBI. We conducted a retrospective cohort study using the National Trauma Data Bank (NTDB) from 2007-2014. We identified a cohort of adult patients with isolated severe TBI, and described the incidence of severe AKI, corresponding to Acute Kidney Injury Network stage 3 disease or greater. We examined the association of severe AKI with the primary outcome of hospital mortality using multivariable logistic regression models. In secondary analyses, we examined the association of severe AKI with dialysis catheter placement, tracheostomy and gastrostomy utilization, and hospital length of stay. There were 37,851 patients who experienced isolated severe TBI during the study period. Among these patients, 787 (2.1%) experienced severe (Stage 3 or greater) AKI. In multivariable models, the development of severe AKI in the hospital was associated with in-hospital mortality (OR 2.03, 95% CI 1.64 – 2.52), need for tracheostomy (OR 2.10, 95% CI 1.52 – 2.89), PEG tube placement (OR 1.88, 95% CI 1.45 – 2.45), and increased hospital length of stay (p<0.001). The overall incidence of severe AKI is relatively low (2.1%), but is associated with increased mortality and multiple markers of increased healthcare utilization following severe TBI.
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影响因子：
38.9
作者：
Mascia, Luciana;Sakr, Yasser;Vincent, Jean-Louis
通讯作者：
Vincent, Jean-Louis
影响因子：
4.1
作者：
Lee, Sungho;Hwang, Hyunsoo;Robertson, Claudia S.
通讯作者：
Robertson, Claudia S.
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作者：
Manley, G;Knudson, MM;Pitts, L
通讯作者：
Pitts, L
影响因子：
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作者：
Maegele, Marc
通讯作者：
Maegele, Marc
影响因子：
2.4
作者：
Rutland-Brown, Wesley;Langlois, Jean A.;Lily, Yongli
通讯作者：
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