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Journal of Investigative Surgery Volume 33, 2020 - Issue 3
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Original Research

Black Race and Body Mass Index Are Risk Factors for Rhabdomyolysis and Acute Kidney Injury in Trauma

Areg GrigorianDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USACorrespondence[email protected]
,
Viktor GabrielDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
,
Ninh T. NguyenDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
,
Brian R. SmithDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
,
Sebastian SchublDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
,
Boris BorazjaniDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
,
Victor JoeDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
&
Jeffry NahmiasDivision of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, California, USA
 show all
Pages 283-290 | Published online: 13 Sep 2018
 
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Abstract

Purpose: Obesity has been shown in a single-center study to be a risk factor for rhabdomyolysis. More recently, sickle cell trait, known to be more prevalent in blacks, has been shown to be a risk factor for rhabdomyolysis. We hypothesized that in trauma patients, black race and a higher body mass index (BMI) are associated with risk for rhabdomyolysis and acute kidney injury (AKI). Materials and Methods: The National Trauma Data Bank (NTDB) was queried (2013–2015) to identify patients age ≥18 years and grouped by BMI: normal (18.5–24.99 kg/m2), underweight (16.5–18.49 kg/m2), overweight (25–29.99 kg/m2), obese (30–34.99 kg/m2), severely obese (35–39.99 kg/m2), and morbidly obese (≥40 kg/m2). A multivariable logistic regression model was used to assess whether a higher BMI or black race was associated with rhabdomyolysis or AKI. Results: After adjusting for covariates, severe obesity (odds ratio (OR) = 1.42, confidence interval (CI) = 1.01–1.99, p < .001), morbid obesity (OR = 1.46, CI = 1.04–2.06, p < .001), and black race (OR = 1.52, CI = 1.24–1.88, p < .001) were associated with higher risk for rhabdomyolysis. Patients that were overweight (OR = 1.17, CI = 1.11–1.24, p < .001), obese (OR = 1.32, CI = 1.24–1.41, p < .001), severely obese (OR = 1.72, CI = 1.59–1.86, p < .001), morbidly obese (OR = 1.77, CI = 1.64–1.92, p < .001), or black (OR = 1.31, CI = 1.24–1.38, p < .001) were associated with higher risk for AKI. Conclusions: Black race was associated with an increased risk of rhabdomyolysis as well as AKI in trauma. BMI ≥25 kg/m2 was associated with increased risk for AKI with the morbidly obese having the highest risk. BMI ≥35 kg/m2 was found to be associated with increased risk of rhabdomyolysis. Future studies should investigate the role for routine screening of these high-risk populations and other potential associated factors such as adherence to weight-based fluid resuscitation.

This article is referred to by:
Higher Body Mass Index and Black Race Increase Risk of Rhabdomyolysis and Acute Kidney Injury After Trauma

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