Severe traumatic brain injury and acute kidney injury patients: factors associated with in-hospital mortality and unfavorable outcomes

ABSTRACT

Objective

The purpose of this study was to identify the occurrence of AKI, and factors associated with in-hospital mortality and unfavorable outcomes in patients with severe traumatic brain injury (TBI) and acute kidney injury (AKI) severity.

Method

A retrospective cohort study which analyzed data with severe TBI between 2013 and 2017. We examined demographic and clinical information, and outcome by in-hospital mortality, and the Glasgow Outcome Scale six months after TBI. We associated factors to in-hospital mortality and unfavorable outcome in severe TBI and AKI with an association test.

Results

A total of 219 patients were selected, 39.3% had an AKI, and several factors associated with AKI occurrence after severe TBI. Stage 2 or 3 of AKI (OR 12.489; 95% CI = 4.45–37.94) were independent risk for both outcomes in multivariable models, severity injury by the New Trauma Injury Severity Score (OR 0.97; 95% CI = 0.96–0.99) for mortality, and the New Injury Severity Score (OR1.07; 95% CI = 1.04–1.10) and Trauma and Injury Severity Score (OR = 0.98; 95% CI = 0.965–0.997) for unfavorable outcome.

Conclusion

The findings of our study confirmed that AKI severity and severity of injury was also related to increased mortality and unfavorable outcome after severe TBI.

KEYWORDS:

• Brain injuries
• acute kidney injury
• risk factors
• mortality
• prognosis
• recovery of function

Acknowledgments

This study was partly financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001, and the Conselho Nacional de Desenvolvimento Cientifico e Tecnológico (CNPq).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

The study concept, design, data acquisition, analysis, and interpretation were performed by RCAV, GLB, WSP, DVO, RMCS. Data were acquired, analyzed, and interpreted by RCAV, GLB, WSP, DVO, CPES, ESS and RMCS. Statistical expertise was provided by CPES. The article was drafted by all authors. Supervision was provided by RCAV, CPES and RMCS. All authors reviewed the final version, which was approved by RCAV, GLB, WSP, DVO, CPES, ESS and RMCS.

Ethical approval

The study was approved by the University of Sao Paulo School of Nursing with protocol number. 4.361.971.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.