Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;35(2):434-440.
doi: 10.1007/s12028-020-01183-z. Epub 2021 Jan 13.

Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury

David Luu  1   2 , Jordan Komisarow  3   2 , Brianna M Mills  4   5 , Monica S Vavilala  4   6 , Daniel T Laskowitz  7 , Joseph Mathew  1 , Michael L James  1   7   2 , Adrian Hernandez  8   9 , John Sampson  3 , Matt Fuller  1   2 , Tetsu Ohnuma  1   2 , Karthik Raghunathan  1   2   9 , Jamie Privratsky  1   2 , Raquel Bartz  1   2 , Vijay Krishnamoorthy  10   11   12
Affiliations

Association of Severe Acute Kidney Injury with Mortality and Healthcare Utilization Following Isolated Traumatic Brain Injury

David Luu et al. Neurocrit Care. 2021 Oct.

Abstract

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.

Keywords: Acute kidney injury; Healthcare utilization; Traumatic brain injury.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None

Figures

Figure 1.
Figure 1.
Outcomes following development of severe AKI
See this image and copyright information in PMC

References

    1. Rutland-Brown W, Langlois JA, Thomas KE, Xi YL. Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil 2006;21:544–8. - PubMed
    1. Saatman KE, Duhaime AC, Bullock R, et al. Classification of traumatic brain injury for targeted therapies. J Neurotrauma 2008;25:719–38. - PMC - PubMed
    1. Mascia L, Sakr Y, Pasero D, Payen D, Reinhart K, Vincent JL. Extracranial complications in patients with acute brain injury: a post-hoc analysis of the SOAP study. Intensive Care Med 2008;34:720–7. - PubMed
    1. Jeremitsky E, Omert L, Dunham CM, Protetch J, Rodriguez A. Harbingers of poor outcome the day after severe brain injury: hypothermia, hypoxia, and hypoperfusion. J Trauma 2003;54:312–9. - PubMed
    1. Manley G, Knudson MM, Morabito D, Damron S, Erickson V, Pitts L. Hypotension, hypoxia, and head injury: frequency, duration, and consequences. Arch Surg 2001;136:1118–23. - PubMed

Publication types

MeSH terms

LinkOut - more resources