Clinical spectrum of acute renal failure in trauma cases: A study from tertiary care center
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 2
Abstract
Background: Acute renal failure (ARF) in the trauma cases is associated with extremely high mortality rates. Understanding the changing spectrum of ARF will be necessary to facilitate quality improvement efforts and to design successful interventional trials. The aim of the present study was to analyze the risk and prognostic factors and final outcome of ARF in patients admitted to trauma care unit. Material and Methods: This prospective study involved patients admitted to emergency surgical wards with clinical history of trauma with clinical and laboratory evidence of ARF. Post trauma ARF was evaluated for risk factors for outcome and need of dialysis like age, sex, refractory hypotension, exposure to nephrotoxic drugs, and exposure to intravenous contrast, time lag, surgical interventions and injury severity score. All patients were followed daily until improved or died. Results: Among 4660 patients admitted during the study period to the trauma ward, ARF developed in 40 patients with an incidence of 0.85%. Average trauma score was 17.4. Thirty-three were survived and seven patients expired. Thirteen patients received dialysis and remaining 27 received conservative management. Refractory hypotension, higher time lag, higher trauma score in expired patients was higher compared to survived patients. Discussion: There is a changing spectrum of ARF in the critically ill, obligating the need for dialysis in the majority of patients due to extra-renal complications. A comprehensive understanding of the clinical spectrum, increased awareness among the resuscitating team and practice patterns of a disease affect the outcome in these patients.
Authors and Affiliations
Neelam N Redkar, Gajanan B Chavan
Keywords
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