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

dc.contributor.author

Luu, David

dc.contributor.author

Komisarow, Jordan

dc.contributor.author

Mills, Brianna M

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Vavilala, Monica S

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Laskowitz, Daniel T

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Mathew, Joseph

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James, Michael L

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Hernandez, Adrian

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Sampson, John

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Fuller, Matt

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Ohnuma, Tetsu

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Raghunathan, Karthik

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Privratsky, Jamie

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Bartz, Raquel

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Krishnamoorthy, Vijay

dc.date.accessioned

2021-10-01T13:34:12Z

dc.date.available

2021-10-01T13:34:12Z

dc.date.issued

2021-01-13

dc.date.updated

2021-10-01T13:34:11Z

dc.description.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 (pā€‰<ā€‰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.
dc.identifier

10.1007/s12028-020-01183-z

dc.identifier.issn

1541-6933

dc.identifier.issn

1556-0961

dc.identifier.uri

https://hdl.handle.net/10161/23868

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

Neurocritical care

dc.relation.isversionof

10.1007/s12028-020-01183-z

dc.subject

Acute kidney injury

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Healthcare utilization

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Traumatic brain injury

dc.title

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

dc.type

Journal article

duke.contributor.orcid

Komisarow, Jordan|0000-0003-3919-7931

duke.contributor.orcid

Laskowitz, Daniel T|0000-0003-3430-8815

duke.contributor.orcid

Mathew, Joseph|0000-0002-3815-4131

duke.contributor.orcid

James, Michael L|0000-0002-8715-5210

duke.contributor.orcid

Hernandez, Adrian|0000-0003-3387-9616

duke.contributor.orcid

Sampson, John|0000-0002-0104-7658

duke.contributor.orcid

Ohnuma, Tetsu|0000-0002-2303-6802

duke.contributor.orcid

Raghunathan, Karthik|0000-0003-2809-5374

duke.contributor.orcid

Privratsky, Jamie|0000-0003-3598-4911

duke.contributor.orcid

Krishnamoorthy, Vijay|0000-0002-1365-4121|0000-0003-4153-2348

pubs.organisational-group

School of Medicine

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Anesthesiology, Critical Care Medicine

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Duke

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Anesthesiology

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Clinical Science Departments

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Faculty

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Duke Clinical Research Institute

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Neurology, Neurocritical Care

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Anesthesiology, Neuroanesthesia

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Institutes and Centers

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Neurology

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Population Health Sciences

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Basic Science Departments

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Medicine, Cardiology

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Medicine

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Biomedical Engineering

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Duke Cancer Institute

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Immunology

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Orthopaedics

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Pathology

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Radiation Oncology

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Neurosurgery

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Pratt School of Engineering

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Trauma, Acute, and Critical Care Surgery

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Surgery

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Anesthesiology, VA Anesthesiology Service

pubs.publication-status

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