TY - JOUR
T1 - Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury
AU - Luu, David
AU - Komisarow, Jordan
AU - Mills, Brianna M.
AU - Vavilala, Monica S.
AU - Laskowitz, Daniel T.
AU - Mathew, Joseph
AU - James, Michael L.
AU - Hernandez, Adrian
AU - Sampson, John
AU - Fuller, Matt
AU - Ohnuma, Tetsu
AU - Raghunathan, Karthik
AU - Privratsky, Jamie
AU - Bartz, Raquel
AU - Krishnamoorthy, Vijay
N1 - Publisher Copyright:
© 2021, Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.
PY - 2021/10
Y1 - 2021/10
N2 - Background/Objective: Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. 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 of severe AKI with hospital mortality and healthcare utilization following isolate severe TBI. Methods: We conducted a retrospective cohort study using the National Trauma Data Bank from 2007 to 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. Results: 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). Conclusions: 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.
AB - Background/Objective: Traumatic brain injury (TBI) is a leading cause of morbidity, mortality, and disability in the USA. 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 of severe AKI with hospital mortality and healthcare utilization following isolate severe TBI. Methods: We conducted a retrospective cohort study using the National Trauma Data Bank from 2007 to 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. Results: 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). Conclusions: 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.
KW - Acute kidney injury
KW - Healthcare utilization
KW - Traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85099420602&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85099420602&partnerID=8YFLogxK
U2 - 10.1007/s12028-020-01183-z
DO - 10.1007/s12028-020-01183-z
M3 - Article
C2 - 33442812
AN - SCOPUS:85099420602
SN - 1541-6933
VL - 35
SP - 434
EP - 440
JO - Neurocritical Care
JF - Neurocritical Care
IS - 2
ER -