Factors Predicting the Severity of Acute Kidney Injuries in Trauma Patients within 48 Hours
Keywords:acute kidney injury, age; co-morbidity, level of consciousness, severity of injury, systematic inﬂammatory response syndrome
Objective: To examine the predictive power of age, comorbidity, severity of injury, level of consciousness, and systematic inﬂammatory response syndrome on trauma patients within 48 hours of receiving acute kidney injuries.
Design: Predictive correlation research.
Methodology: The subjects were 170 trauma patients receiving treatment in the intensive care units of Pattani Hospital, Yala Regional Hospital, Naradhiwas Rajanagarindra Hospital, and Su-ngaikolok Hospital. The data-gathering instruments were 1) a demographic record form; 2) the Injury Severity Score (ISS); 3) the Glasgow Coma Score (GCS), 4) a co-morbidity assessment form; 5) the Systematic Inﬂammatory Response Syndrome Score (SIRS Score); and 6) the Kidney Disease Improving Global Outcomes Clinical Practice Guideline (KDIGO). The correlations were analysed using Point Bi-serial Correlation, whilst predictive power was examined using Logistic Regression Analysis.
Results:The majority of the subjects (78.8%) were male, averagely aged 39.58 years (SD = 17.37). One-third (30%) of the subjects displayed co-morbidity, and nearly half were suffering from severe injuries and had a moderate level of consciousness (47.6% and 46.5%, respectively). The systematic inﬂammatory response syndrome was detected in 86.5% of the subjects. On the other hand, acute kidney injuries were found only in 11.8% of the subjects. Based on the results, the severity of injury and systematic inﬂammatory response syndrome were signifcant factors jointly predicting up to 30% of acute kidney injury incidences in trauma patients within the frst 48 hours of injury (Nagelkerke R2 = .30).
Recommendations:It is highly recommended that nurses thoroughly assess trauma patients’ AKI within the frst 48 hours of injury. Nurses also should use the information on the patients’ injury severity and SIRS for early monitoring and prevention of the development of AKI.
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