Associations between hollow viscus injury and acute kidney injury in blunt abdominal trauma: A national trauma data bank analysis

Pei Hua Li, Chih Yuan Fu, Faran Bokhari

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations

Abstract

PURPOSE: It is well established that hollow viscus perforation leads to sepsis and acute kidney injury (AKI) in non-trauma patients. However, the relationship between traumatic hollow viscus injury (HVI) and AKI is not well understood. Utilizing data from the National Trauma Data Bank, we investigated whether HVI serves as a risk factor for AKI. Additionally, we examined the characteristics of AKI in stable patients who underwent conservative treatment.

METHODS: We reviewed blunt abdominal trauma (BAT) cases from 2012 to 2015, comparing patients with and without AKI. Significant factors from univariate analysis were tested in a multivariate logistic regression (MLR) to identify independent AKI determinants. We also analyzed subsets: patients without HVI and stable patients given conservative management.

RESULTS: Out of the 563,040 BAT patients analyzed, 9073 (1.6%) developed AKI. While a greater proportion of AKI patients had HVI than those without AKI (13.3% vs. 5.2%, p < 0.001), this difference wasn't statistically significant in the MLR (p = 0.125). Notably, the need for laparotomy (odds = 3.108, p < 0.001) and sepsis (odds = 13.220, p < 0.001) were identified as independent risk factors for AKI. For BAT patients managed conservatively (systolic blood pressure >90 mmHg, without HVI or laparotomy; N = 497,066), the presence of sepsis was a significant predictor for the development of AKI (odds = 16.914, p < 0.001).

CONCLUSIONS: While HVI wasn't a significant risk factor for AKI in BAT patients, the need for laparotomy was. Stable BAT patients managed conservatively are still at risk for AKI due to non-peritonitis related sepsis.

Original languageEnglish
Pages (from-to)2292-2299
Number of pages8
JournalWorld Journal of Surgery
Volume48
Issue number9
DOIs
StatePublished - 01 09 2024

Bibliographical note

© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).

Keywords

  • acute kidney injury
  • blunt abdominal trauma
  • hollow viscus injury
  • laparotomy
  • sepsis
  • Humans
  • Middle Aged
  • Risk Factors
  • Male
  • Logistic Models
  • Acute Kidney Injury/etiology
  • Abdominal Injuries/complications
  • Young Adult
  • United States/epidemiology
  • Wounds, Nonpenetrating/complications
  • Sepsis/epidemiology
  • Conservative Treatment/methods
  • Female
  • Adult
  • Retrospective Studies
  • Aged
  • Databases, Factual

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