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Abstract: PO0015

Prehospital Systolic Blood Pressure and Lactate Are Early Predictors of AKI After Trauma: A Prospective Validation Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Nasu, Toru, Wakayama Medical University, Wakayama, Wakayama, Japan
  • Ueda, Kentaro, Wakayama Medical University, Wakayama, Wakayama, Japan
  • Kawashima, Shuji, Wakayama Medical University, Wakayama, Wakayama, Japan
  • Okishio, Yuko, Wakayama Medical University, Wakayama, Wakayama, Japan
  • Kunitatsu, Kosei, Wakayama Medical University, Wakayama, Wakayama, Japan
  • Iwasaki, Yasuhiro, Wakayama Rosai Hospital, Wakayama, Japan
  • Kato, Seiya, Wakayama Medical University, Wakayama, Wakayama, Japan
Background

We have already reported that prehospital systolic blood pressure and lactate can be predictive factors for acute kidney injury (AKI) after trauma. This study is a prospective validation study to determine whether these risk factors are helpful.

Methods

We evaluated all trauma patients who were admitted from January 2019 to December 2019. Patients who were <16 years of age, patients with burns, and patients with chronic kidney disease were excluded from the present study. AKI was defined according to the risk, injury, failure, loss of the kidney function, and end-stage kidney disease (RIFLE) classification from serum creatinine alone.

Results

Four hundred -three patients were included in the analysis. The prevalence of AKI in the overall population was 14.7% including 11.7% of patients with stage R, 2.0% of patients with stage I and 1.0% with stage F. The incidence of stage I and F AKI in the high-risk group (5 of 38 patients, with the positive predictive value of 13.2%) was significantly higher (P<0.001) than that in the low-risk group (7 of 358 patients, with the negative predictive value of 98.1%).

Conclusion

The prehospital systolic blood pressure and early hospital arterial lactate showed good performance in the early prediction of AKI after trauma. These parameters are associated with the early onset of AKI after trauma and may be an early predictor of the effects of treatment to prevent AKI.