title: The incidence of acute kidney injury in patients with traumatic brain injury.
abstract: There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with risk factors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize renal function. The incidence of AKI was 9.2% (19/207). Patients who developed AKI were older, had higher severity of illness scores, and a lower GCS. Overall 42.1% of these patients died in hospital compared with 18.1% in patients without AKI. In univariable linear regression analysis, age, severity of illness, and admitting hospital were associated with AKI. After multivariable logistic regression, the occurrence of AKI was associated with age (p < 0.001) and higher APACHE III scores (p = 0.016). AKI is relatively common even in patients with TBI. Its association with age and APACHE III scores helps identify patients at higher risk of AKI.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care (ANZIC) Research Centre, Monash University, Melbourne, VIC, Australia. Elizabeth.Moore@med.monash.edu.au
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Moore
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: Alistair
authors.initials: A
authors.lastname: Nichol
authors.forename: Nerina
authors.initials: N
authors.lastname: Harley
authors.forename: Christopher
authors.initials: C
authors.lastname: Macisaac
authors.forename: D James
authors.initials: DJ
authors.lastname: Cooper
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology