Risk factors and outcome of acute kidney injury in elderly trauma patients

Abstract

Background: Acute Kidney Injury (AKI) is associated with significant morbidity. The risk factors for AKI in elderly trauma patients have not been defined.

Methods: Injured patients 75 years old or older from 2014 to 2016 were evaluated. AKI was identified by RIFLE criteria. Patients with and without AKI were compared with chi square, ANOVA, and logistic regression.

Results: 836 patients were 75 years old or older. Patients with AKI were more commonly male, hypotensive on admission with a greater Injury Severity Score but age, diabetes, hypertension and baseline creatinine were similar. Patients with AKI had a higher mortality that did not increase with RIFLE stage. Male sex, ISS, hypotension on admission and presence of an extremity injury were independently associated with AKI by logistic regression.

Conclusion: AKI in elderly trauma patients is associated with magnitude of injury and shock but not pre-existing medical comorbidities and it significantly increased the risk of death.

Keywords: Acute kidney injury; Renal failure; Shock; Trauma.