- The Risk Factors for Developing Contrast-induced Nephropathy after the Evaluation of Trauma Patients at a Regional Trauma Center in Korea
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Yoo Mi An, Soon Chang Park, Hyung Bin Kim, Young Mo Cho, Dae Seop Lee, Yong In Kim, Sang Kyun Han
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J Trauma Inj. 2016;29(4):124-128. Published online December 31, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.4.124
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 Abstract
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- PURPOSE
Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of trauma patients; however, the risk factors for contrast-induced nephropathy (CIN) in these patients remain unclear. This study determined the rate of CIN in trauma patients at a regional trauma center in Korea and identified the risk factors for developing CIN.
METHODS
We retrospectively reviewed the medical records of 138 patients for the patient demographics, creatinine levels, and vital signs. CIN was defined as an increase in creatinine by 0.5 mg/dL from admission after undergoing CT with IV contrast.
RESULTS
Of the patients, 7.2% developed CIN during their admission after receiving IV contrast for CT. In the multivariate analysis, only the creatinine level at presentation (Adjusted odds ratio [aOR], 5.944; 95% confidence interval [CI], 1.486-23.733; p=0.012) and an injury severity score (ISS) greater than 22 (aOR, 1.096; 95% CI, 1.021-1.176; p=0.011) were independently associated with the risk of CIN.
CONCLUSION
CIN is uncommon in trauma patients following CT with IV contrast. The creatinine level at presentation and ISS were independent risk factors for developing CIN in trauma patients.
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Summary
- Why do Multiple-trauma Patients Stay Longer in the Intensive Care Unit?; A Comparison of Injury Severity Score and The Number of Injured Regions
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Mu Jin Jo, Seong Hwa Lee, Seok Ju Cho, Seok Ran Yeom, Sang Kyoon Han, Sung Wook Park, Dae Seop Lee
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J Trauma Inj. 2013;26(2):47-52.
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Abstract
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- PURPOSE
Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions.
METHODS
For 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups.
RESULTS
In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions.
CONCLUSION
Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.
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