Acute posttraumatic renal failure

A multicenter perspective

J. A. Morris, P. Mucha, S. E. Ross, B. F A Moore, D. B. Hoyt, L. Gentilello, J. Landercasper, D. V. Feliciano, S. R. Shackford, E. J. Rutherford, T. R. Wilcox, M. Rhodes, K. A. Illig, E. E. Moore, R. Mackersie, G. Jurkovich, T. H. Cogbill, K. F. O'Malley, J. D. Schmoker, S. M. Bass

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098%) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70% increase in mortality over those without pre-existing conditions (p < 0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82%). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18%) were discharged with renal insufficiency, three (9%) were discharged on dialysis, 23 (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant evidence of renal insufficiency. Conclusion: Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57%). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation.

Original languageEnglish (US)
Pages (from-to)1584-1590
Number of pages7
JournalJournal of Trauma
Volume31
Issue number12
StatePublished - 1991

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Acute Kidney Injury
Renal Insufficiency
Multiple Organ Failure
Preexisting Condition Coverage
Mortality
Trauma Centers
Renal Dialysis
Dialysis
Wounds and Injuries
Resuscitation
Survivors
Cause of Death
Rehabilitation
Demography
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Morris, J. A., Mucha, P., Ross, S. E., Moore, B. F. A., Hoyt, D. B., Gentilello, L., ... Bass, S. M. (1991). Acute posttraumatic renal failure: A multicenter perspective. Journal of Trauma, 31(12), 1584-1590.

Acute posttraumatic renal failure : A multicenter perspective. / Morris, J. A.; Mucha, P.; Ross, S. E.; Moore, B. F A; Hoyt, D. B.; Gentilello, L.; Landercasper, J.; Feliciano, D. V.; Shackford, S. R.; Rutherford, E. J.; Wilcox, T. R.; Rhodes, M.; Illig, K. A.; Moore, E. E.; Mackersie, R.; Jurkovich, G.; Cogbill, T. H.; O'Malley, K. F.; Schmoker, J. D.; Bass, S. M.

In: Journal of Trauma, Vol. 31, No. 12, 1991, p. 1584-1590.

Research output: Contribution to journalArticle

Morris, JA, Mucha, P, Ross, SE, Moore, BFA, Hoyt, DB, Gentilello, L, Landercasper, J, Feliciano, DV, Shackford, SR, Rutherford, EJ, Wilcox, TR, Rhodes, M, Illig, KA, Moore, EE, Mackersie, R, Jurkovich, G, Cogbill, TH, O'Malley, KF, Schmoker, JD & Bass, SM 1991, 'Acute posttraumatic renal failure: A multicenter perspective', Journal of Trauma, vol. 31, no. 12, pp. 1584-1590.
Morris JA, Mucha P, Ross SE, Moore BFA, Hoyt DB, Gentilello L et al. Acute posttraumatic renal failure: A multicenter perspective. Journal of Trauma. 1991;31(12):1584-1590.
Morris, J. A. ; Mucha, P. ; Ross, S. E. ; Moore, B. F A ; Hoyt, D. B. ; Gentilello, L. ; Landercasper, J. ; Feliciano, D. V. ; Shackford, S. R. ; Rutherford, E. J. ; Wilcox, T. R. ; Rhodes, M. ; Illig, K. A. ; Moore, E. E. ; Mackersie, R. ; Jurkovich, G. ; Cogbill, T. H. ; O'Malley, K. F. ; Schmoker, J. D. ; Bass, S. M. / Acute posttraumatic renal failure : A multicenter perspective. In: Journal of Trauma. 1991 ; Vol. 31, No. 12. pp. 1584-1590.
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abstract = "Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098{\%}) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70{\%} increase in mortality over those without pre-existing conditions (p < 0.004). Twenty-four patients (31{\%}) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82{\%}). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18{\%}) were discharged with renal insufficiency, three (9{\%}) were discharged on dialysis, 23 (70{\%}) were discharged home or to rehabilitation, and 27 (82{\%}) had no significant evidence of renal insufficiency. Conclusion: Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57{\%}). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation.",
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T1 - Acute posttraumatic renal failure

T2 - A multicenter perspective

AU - Morris, J. A.

AU - Mucha, P.

AU - Ross, S. E.

AU - Moore, B. F A

AU - Hoyt, D. B.

AU - Gentilello, L.

AU - Landercasper, J.

AU - Feliciano, D. V.

AU - Shackford, S. R.

AU - Rutherford, E. J.

AU - Wilcox, T. R.

AU - Rhodes, M.

AU - Illig, K. A.

AU - Moore, E. E.

AU - Mackersie, R.

AU - Jurkovich, G.

AU - Cogbill, T. H.

AU - O'Malley, K. F.

AU - Schmoker, J. D.

AU - Bass, S. M.

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N2 - Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098%) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70% increase in mortality over those without pre-existing conditions (p < 0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82%). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18%) were discharged with renal insufficiency, three (9%) were discharged on dialysis, 23 (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant evidence of renal insufficiency. Conclusion: Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57%). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation.

AB - Acute renal failure (ARF) following trauma is rare. Historically, ARF has been associated with a high mortality rate. To investigate this entity we conducted a retrospective review of 72,757 admissions treated at nine regional trauma centers over a 5-year period. Seventy-eight patients (0.098%) developed acute renal failure requiring hemodialysis. Detailed demographic, clinical, and outcome data were collected. Patients with pre-existing medical conditions (group I) had a 70% increase in mortality over those without pre-existing conditions (p < 0.004). Twenty-four patients (31%) developed ARF less than 6 days after injury (group II). The remainder (group III) developed late renal failure (mean time to first dialysis, 23 days). The predominant cause of death was multiple organ failure (82%). There were no differences in mortality because of multiple organ failure among the three groups of patients. Of the 33 survivors, six (18%) were discharged with renal insufficiency, three (9%) were discharged on dialysis, 23 (70%) were discharged home or to rehabilitation, and 27 (82%) had no significant evidence of renal insufficiency. Conclusion: Posttraumatic renal failure requiring hemodialysis is rare (incidence, 107 per 100,000 trauma center admissions), but the mortality rate remains high (57%). Two thirds of the cases of posttraumatic renal failure develop late and are secondary to multiple organ failure; one third of the cases of posttraumatic renal failure develop early and may result from inadequate resuscitation.

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