Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study

Abstract Acute kidney injury (AKI) is a frequent complication of traumatic injury; however, long-term outcomes such as mortality and end-stage kidney disease (ESKD) have been rarely reported in this important patient population. We compared the long-term outcome of vehicle-traumatic and non-traumati...

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Autores principales:	Chieh-Kai Chan, Chun-Yi Chi, Tai-Shuan Lai, Tao-Min Huang, Nai-Kuan Chou, Yi-Ping Huang, John R. Prowle, Vin-Cent Wu, Yung-Ming Chen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ba29e5b9c4274bdd95160ca2cd03172e
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spelling	oai:doaj.org-article:ba29e5b9c4274bdd95160ca2cd03172e2021-12-02T11:40:41ZLong-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study10.1038/s41598-020-77556-32045-2322https://doaj.org/article/ba29e5b9c4274bdd95160ca2cd03172e2020-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-77556-3https://doaj.org/toc/2045-2322Abstract Acute kidney injury (AKI) is a frequent complication of traumatic injury; however, long-term outcomes such as mortality and end-stage kidney disease (ESKD) have been rarely reported in this important patient population. We compared the long-term outcome of vehicle-traumatic and non-traumatic AKI requiring renal replacement therapy (AKI-RRT). This nationwide cohort study used data from the Taiwan National Health Insurance Research Database. Vehicle-trauma patients who were suffered from vehicle accidents developing AKI-RRT during hospitalization were identified, and matching non-traumatic AKI-RRT patients were identified between 2000 and 2010. The incidences of ESKD, 30-day, and long-term mortality were evaluated, and clinical and demographic associations with these outcomes were identified using Cox proportional hazards regression models. 546 vehicle-traumatic AKI-RRT patients, median age 47.6 years (interquartile range: 29.0–64.3) and 76.4% male, were identified. Compared to non-traumatic AKI-RRT, vehicle-traumatic AKI-RRT patients had longer length of stay in hospital [median (IQR):15 (5–34) days vs. 6 (3–11) days; p < 0.001). After propensity matching with non-traumatic AKI-RRT cases with similar demographic and clinical characteristics. Vehicle-traumatic AKI-RRT patients had lower rates of long-term mortality (adjusted hazard ratio (HR), 0.473; 95% CI, 0.392–0.571; p < 0.001), but similar rates of ESKD (HR, 1.166; 95% CI, 0.829–1.638; p = 0.377) and short-term risk of death (HR, 1.134; 95% CI, 0.894–1.438; p = 0.301) as non-traumatic AKI-RRT patients. In competing risk models that focused on ESKD, vehicle-traumatic AKI-RRT patients were associated with lower ESKD rates (HR, 0.552; 95% CI, 0.325–0.937; p = 0.028) than non-traumatic AKI-RRT patients. Despite severe injuries, vehicle-traumatic AKI-RRT patients had better long-term survival than non-traumatic AKI-RRT patients, but a similar risk of ESKD. Our results provide a better understanding of long-term outcomes after vehicle-traumatic AKI-RRT.Chieh-Kai ChanChun-Yi ChiTai-Shuan LaiTao-Min HuangNai-Kuan ChouYi-Ping HuangJohn R. ProwleVin-Cent WuYung-Ming ChenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-9 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chieh-Kai Chan Chun-Yi Chi Tai-Shuan Lai Tao-Min Huang Nai-Kuan Chou Yi-Ping Huang John R. Prowle Vin-Cent Wu Yung-Ming Chen Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
description	Abstract Acute kidney injury (AKI) is a frequent complication of traumatic injury; however, long-term outcomes such as mortality and end-stage kidney disease (ESKD) have been rarely reported in this important patient population. We compared the long-term outcome of vehicle-traumatic and non-traumatic AKI requiring renal replacement therapy (AKI-RRT). This nationwide cohort study used data from the Taiwan National Health Insurance Research Database. Vehicle-trauma patients who were suffered from vehicle accidents developing AKI-RRT during hospitalization were identified, and matching non-traumatic AKI-RRT patients were identified between 2000 and 2010. The incidences of ESKD, 30-day, and long-term mortality were evaluated, and clinical and demographic associations with these outcomes were identified using Cox proportional hazards regression models. 546 vehicle-traumatic AKI-RRT patients, median age 47.6 years (interquartile range: 29.0–64.3) and 76.4% male, were identified. Compared to non-traumatic AKI-RRT, vehicle-traumatic AKI-RRT patients had longer length of stay in hospital [median (IQR):15 (5–34) days vs. 6 (3–11) days; p < 0.001). After propensity matching with non-traumatic AKI-RRT cases with similar demographic and clinical characteristics. Vehicle-traumatic AKI-RRT patients had lower rates of long-term mortality (adjusted hazard ratio (HR), 0.473; 95% CI, 0.392–0.571; p < 0.001), but similar rates of ESKD (HR, 1.166; 95% CI, 0.829–1.638; p = 0.377) and short-term risk of death (HR, 1.134; 95% CI, 0.894–1.438; p = 0.301) as non-traumatic AKI-RRT patients. In competing risk models that focused on ESKD, vehicle-traumatic AKI-RRT patients were associated with lower ESKD rates (HR, 0.552; 95% CI, 0.325–0.937; p = 0.028) than non-traumatic AKI-RRT patients. Despite severe injuries, vehicle-traumatic AKI-RRT patients had better long-term survival than non-traumatic AKI-RRT patients, but a similar risk of ESKD. Our results provide a better understanding of long-term outcomes after vehicle-traumatic AKI-RRT.
format	article
author	Chieh-Kai Chan Chun-Yi Chi Tai-Shuan Lai Tao-Min Huang Nai-Kuan Chou Yi-Ping Huang John R. Prowle Vin-Cent Wu Yung-Ming Chen
author_facet	Chieh-Kai Chan Chun-Yi Chi Tai-Shuan Lai Tao-Min Huang Nai-Kuan Chou Yi-Ping Huang John R. Prowle Vin-Cent Wu Yung-Ming Chen
author_sort	Chieh-Kai Chan
title	Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
title_short	Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
title_full	Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
title_fullStr	Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
title_full_unstemmed	Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
title_sort	long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/ba29e5b9c4274bdd95160ca2cd03172e
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Long-term outcomes following vehicle trauma related acute kidney injury requiring renal replacement therapy: a nationwide population study

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