Association of AKI with Adverse Outcomes in Burned Military Casualties

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; 95%confidence interval [CI], 1.75 134; P=0.01), 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; P=0.008); 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.

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Document Details

Document Type
Technical Report
Publication Date
Feb 01, 2012
Accession Number
ADA618591

Entities

People

  • Casey L. Cotant
  • Christopher Gisler
  • Evan M. Renz
  • Hana K. Kwan
  • Ian J Stewart
  • James Keith Aden
  • Jeffery Mccorcle
  • Kevin K Chung
  • Molly A. Tilley

Organizations

  • United States Army Institute of Surgical Research

Tags

DTIC Thesaurus Topics

  • Blood
  • Brain Injuries
  • Burns
  • Casualties
  • Health Services
  • Hospitals
  • Kidney Diseases
  • Lung Diseases
  • Medical Personnel
  • Military Personnel
  • Therapy
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

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