Accession Number:

ADA618591

Title:

Association of AKI with Adverse Outcomes in Burned Military Casualties

Descriptive Note:

Journal article

Corporate Author:

ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX

Report Date:

2012-02-01

Pagination or Media Count:

9.0

Abstract:

Background and objectives Although associated with increased morbidity and mortality, AKI has not been systematically examined in military personnel injured from combat operations in Iraq and Afghanistan. Design, settings, participants, measurements Patients evacuated from Iraq and Afghanistan to a burn unit were examined. AKI was classified by the Acute Kidney Injury Network AKIN and Risk-Injury-Failure-Loss-End Stage RIFLE schemas. Age, sex, percentage of total body surface area burned TBSA, percentage of full thickness burn, inhalation injury, and injury severity score were recorded. Additional data that could be associated with poor outcomes were recorded for patients with TBSA 20. Multivariate logistic regression analyses were performed to determine factors associated with morbidity and mortality. Results AKI prevalence rates by the RIFLE and AKIN criteria were 23.8 and 29.9, respectively. After logistic regression, RIFLE categories of risk odds ratio OR, 15.34 95confidence interval CI, 1.75 134 P0.01, injury OR, 46.28 95 CI, 5.02 427 P,0.001, and failure OR, 126 95 CI, 13.39 .999 P,0.001 AKIN-2 OR, 23.70 95 CI, 2.32 242 P0.008 and AKIN-3 OR, 130 95 CI, 13.38 .999 P,0.001 were significantly associated with death. AKIN-3, injury, and failure remained significant in the subset of patients with 20 TBSA. There was also a strong interaction between TBSA and the stage of AKI with respect to ventilator and intensive care unit days. Conclusions AKI is prevalent in military casualties with burn injury and is independently associated with morbidity and mortality after adjustment for factors associated with injury severity.

Subject Categories:

  • Anatomy and Physiology
  • Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE