Prevalence and outcome of contrast-induced nephropathy in major trauma patients
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ORIGINAL ARTICLE
Prevalence and outcome of contrast‑induced nephropathy in major trauma patients Julian Alexander Kelemen1 · Alexander Kaserer2 · Kai Oliver Jensen1 · Philipp Stein2,4 · Burkhardt Seifert3,5 · Hans‑Peter Simmen1 · Donat R. Spahn2 · Hans‑Christoph Pape1 · Valentin Neuhaus1 Received: 27 April 2020 / Accepted: 4 September 2020 © The Author(s) 2020
Abstract Background Contrast-induced nephropathy (CIN) has been well investigated in patients undergoing coronary angiography, but not in trauma patients. The main aim of this study was to determine the prevalence and to investigate independent risk factors for the development of CIN. Methods Between 2008 and 2014, all pre-hospital intubated major trauma patients with documented serum creatinine levels (SCr) undergoing a contrast-enhanced whole-body CT at admission were retrospectively analyzed. CIN was defined as a relative increase in SCr > 25% over the baseline value or an absolute SCr increase of > 44 µmol/l within 72 h. Univariate and multivariable regression analyses were performed to identify significant risk factors. A p value of 25% of the baseline value or an absolute increase > 44 µmol/l within 72 h [6]. Complications were defined as the presence of acute delirium, myocardial infarction, deep vein thrombosis, pulmonary embolism, urinary tract infection, surgical site infection or complications such as pneumonia, sepsis, SIRS, cerebrovascular incidents or coagulopathy during the hospitalization [21].
Study endpoints The main goal of this study was to determine prevalence of and to identify independent risk factors for CIN. Additionally, we assessed the clinical impact of CIN on the need of hemodialysis, complications rates, length of stay and mortality.
Statistical analyses Categorical data are reported as frequency and percent and numerical data as mean ± standard deviation (SD). The Chi‐ square and Fisher’s exact test were used to compare categorical data and the Mann–Whitney U-test for numerical data. Age, gender, Injury Severity Score for anatomic severity, and lactate level for physiologic severity were entered in multiple regression analysis as suggested by Haider et al. (“Bare minimum”) [22]. In addition, CIN was forced into the models where applicable. Model fit was assessed using the Hosmer–Lemeshow test. The Glasgow Coma Scale and need for ventilator use were not used in these models since all patients were intubated at arrival. Lactate level was skewed to the right and therefore logarithmically transformed. All statistical analyses were performed by IBM SPSS Statistics 23 (IBM Corp., Armonk, NY, USA). Missing values were not entered into the analysis. A
p value of
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