Incidence of, Risk Factors for, and Mortality Associated With Severe Acute Kidney Injury After Gunshot Wound

Athavale, Ambarish M.; Fu, Chih-Yuan; Bokhari, Faran; Bajani, Francesco; Hart, Peter D.

doi:10.1001/jamanetworkopen.2019.17254

Cited by 10 publications

(6 citation statements)

References 26 publications

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“…Age was an independent risk factor for the initiation, development, and adverse outcome of AKI 27 , 28 . This study represented the analysis of AKI among hospitalized elderly patients in China.…”

Section: Discussionmentioning

confidence: 96%

Development of mortality prediction model in the elderly hospitalized AKI patients

Peng

et al. 2021

Sci Rep

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Acute kidney injury (AKI) correlates with increased health-care costs and poor outcomes in older adults. However, there is no good scoring system to predict mortality within 30-day, 1-year after AKI in older adults. We performed a retrospective analysis screening data of 53,944 hospitalized elderly patients (age > 65 years) from multi-centers in China. 944 patients with AKI (acute kidney disease) were included and followed up for 1 year. Multivariable regression analysis was used for developing scoring models in the test group (a randomly 70% of all the patients). The established models have been verified in the validation group (a randomly 30% of all the patients). Model 1 that consisted of the risk factors for death within 30 days after AKI had accurate discrimination (The area under the receiver operating characteristic curves, AUROC: 0.90 (95% CI 0.875–0.932)) in the test group, and performed well in the validation groups (AUROC: 0.907 (95% CI 0.865–0.949)). The scoring formula of all-cause death within 1 year (model 2) is a seven-variable model including AKI type, solid tumor, renal replacement therapy, acute myocardial infarction, mechanical ventilation, the number of organ failures, and proteinuria. The area under the receiver operating characteristic (AUROC) curves of model 2 was > 0.80 both in the test and validation groups. Our newly established risk models can well predict the risk of all-cause death in older hospitalized AKI patients within 30 days or 1 year.

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Section: Discussionmentioning

confidence: 96%

Development of mortality prediction model in the elderly hospitalized AKI patients

Peng

et al. 2021

Sci Rep

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“…Multiple studies have revealed that AKI is common and associated with poor clinical outcomes in EDs [ 2 – 4 ], emergency hospitalization [ 5 ], hospital wards [ 6 ], and intensive care units (ICUs) [ 7 – 9 ]. AKI development is also associated with a higher mortality rate in various clinical contexts, including sepsis [ 10 – 12 ], cardiogenic shock [ 13 ], chest pain [ 14 ], gunshot wound [ 15 ], emergent laparotomy [ 16 ], and out-of-hospital cardiac arrest [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Estimated glomerular filtration rate may be an independent predictor for clinical outcomes regardless of acute kidney injury complication in the emergency department

2021

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Study objective Acute kidney injury (AKI), chronic kidney disease (CKD), and decreased estimated glomerular filtration rate (eGFR) are all associated with poor clinical outcomes among emergency department (ED) patients. This study aimed to evaluate the effect of different types of renal dysfunction and the degree of eGFR reduction on the clinical outcomes in a real-world ED setting. Methods Adult patients with an eGFR lower than 60 mL/min/1.73m2 in our ED, from October 1, 2016, to December 31, 2016, were enrolled in this retrospective observational study. Besides AKI and CKD, patients with unknown baseline renal function before an ED visit were categorized in the undetermined renal dysfunction (URD) category. Results Among 1495 patients who had eGFR evaluation at ED, this study finally enrolled 441 patients; 22 patients (5.0%) had AKI only, 32 (7.3%) had AKI on CKD, 196 (44.4%) had CKD only, 27 (6.1%) had subclinical kidney injury (those who met neither criteria for AKI nor CKD), and 164 (37.2%) had URD. There was a significant association between eGFR and critical illness defined as the composite outcome of death or intensive care unit (ICU) need, hospitalization, ICU need, death, and renal replacement therapy need (odds ratio [95% confidence interval]: 1.72 [1.45–2.05], 1.36 [1.16–1.59], 1.66 [1.39–2.00], 1.73 [1.32–2.28], and 2.71 [1.73–4.24] for every 10 mL/min/1.73m2 of reduction, respectively). Multivariate logistic regression analysis showed eGFR was an independent predictor of critical illness composite outcome (death or ICU need), hospitalization, and ICU need even after adjustment with AKI or URD. Conclusions Estimated GFR may be a sufficient predictor of clinical outcomes of ED patients regardless of AKI complication. Considerable ED patients were determined as URD, which might have a significant impact on the ED statistics regarding renal dysfunction.

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“…Acute Kidney Injury (AKI) is characterized by a sudden decrease in the renal function 1 . It represents a severe health condition worldwide, as it exerts several impacts on survival and increases the risk of progression to Chronic Kidney Disease (CKD) 2 .…”

Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors and Survival of Critically-Ill Patients With Acute Kidney Injury

Lopes¹,

Araújo²,

Prado³

et al. 2021

Texto contexto - enferm.

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Objective: to analyze the incidence, risk factors and survival of critically-ill patients with acute kidney injury. Method: a concurrent cohort study, conducted with 126 participants between May and September 2019 in a public Intensive Care Unit of the state of Acre. The Kaplan-Meier method was used to estimate the probability of death (log-rank 95% test) and the Cox regression model was employed to determine the prognostic factors of death. Results: the incidence of acute kidney injury was 37.3 per 1,000 individuals admitted to the intensive Care Unit. Disease recovery was the outcome in 36.7% of the patients, and 42.9% evolved to death. The conditional probability of death was higher in the female gender and in those who did not use mechanical ventilation, with glomerular filtration rate at admission < 60 ml/min/1.73 m 2 and sepsis diagnosis. Regardless of the acute kidney injury diagnosis, the risk factors associated with death in the population of critically-ill patients were serum creatinine above 1.2 mg/dl at admission and glomerular filtration rate < 60 ml/min/1.73 m 2 at admission. Conclusion: in this population, survival is aggravated by gender dimorphism and by the reduction of the glomerular filtration rate.

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Incidence of, Risk Factors for, and Mortality Associated With Severe Acute Kidney Injury After Gunshot Wound

Cited by 10 publications

References 26 publications

Development of mortality prediction model in the elderly hospitalized AKI patients

Development of mortality prediction model in the elderly hospitalized AKI patients

Estimated glomerular filtration rate may be an independent predictor for clinical outcomes regardless of acute kidney injury complication in the emergency department

Incidence, Risk Factors and Survival of Critically-Ill Patients With Acute Kidney Injury

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