Acute kidney injury risk in orthopaedic trauma patients pre and post surgery using a biomarker algorithm and clinical risk score
Acute kidney injury (AKI) after major trauma is associated with increased mortality. The aim of this study was to assess if measurement of blood biomarkers in combination with clinical characteristics could be used to develop a tool to assist clinicians in identifying which orthopaedic trauma patien...
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description | Acute kidney injury (AKI) after major trauma is associated with increased mortality. The aim of this study was to assess if measurement of blood biomarkers in combination with clinical characteristics could be used to develop a tool to assist clinicians in identifying which orthopaedic trauma patients are at risk of AKI. This is a prospective study of 237 orthopaedic trauma patients who were consecutively scheduled for open reduction and internal fixation of their fracture between May 2012 and August 2013. Clinical characteristics were recorded, and 28 biomarkers were analysed in patient blood samples. Post operatively a combination of H-FABP, sTNFR1 and MK had the highest predictive ability to identify patients at risk of developing AKI (AUROC 0.885). Three clinical characteristics; age, dementia and hypertension were identified in the orthopaedic trauma patients as potential risks for the development of AKI. Combining biomarker data with clinical characteristics allowed us to develop a proactive AKI clinical tool, which grouped patients into four risk categories that were associated with a clinical management regime that impacted patient care, management, length of hospital stay, and efficient use of hospital resources. |
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The aim of this study was to assess if measurement of blood biomarkers in combination with clinical characteristics could be used to develop a tool to assist clinicians in identifying which orthopaedic trauma patients are at risk of AKI. This is a prospective study of 237 orthopaedic trauma patients who were consecutively scheduled for open reduction and internal fixation of their fracture between May 2012 and August 2013. Clinical characteristics were recorded, and 28 biomarkers were analysed in patient blood samples. Post operatively a combination of H-FABP, sTNFR1 and MK had the highest predictive ability to identify patients at risk of developing AKI (AUROC 0.885). Three clinical characteristics; age, dementia and hypertension were identified in the orthopaedic trauma patients as potential risks for the development of AKI. Combining biomarker data with clinical characteristics allowed us to develop a proactive AKI clinical tool, which grouped patients into four risk categories that were associated with a clinical management regime that impacted patient care, management, length of hospital stay, and efficient use of hospital resources.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-020-76929-y</identifier><identifier>PMID: 33203963</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308 ; 692/4022 ; 692/420 ; 692/499 ; 692/53 ; Acute Kidney Injury - diagnosis ; Acute Kidney Injury - etiology ; Age Factors ; Aged ; Aged, 80 and over ; Biomarkers ; Biomarkers - blood ; Blood ; Dementia ; Dementia disorders ; Fatty Acid Binding Protein 3 - blood ; Fatty acid-binding protein ; Female ; Health risks ; Humanities and Social Sciences ; Humans ; Hypertension ; Kidneys ; Male ; Midkine - blood ; multidisciplinary ; Multidisciplinary Sciences ; Musculoskeletal Diseases - complications ; Orthopedics ; Patients ; Perioperative Care - methods ; Predictive Value of Tests ; Prospective Studies ; Risk Factors ; Science ; Science & Technology ; Science & Technology - Other Topics ; Science (multidisciplinary) ; Surgery ; Trauma ; Trauma centers ; Tumor Necrosis Factor-alpha - blood ; Wounds and Injuries - blood ; Wounds and Injuries - complications ; Wounds and Injuries - surgery</subject><ispartof>Scientific reports, 2020-11, Vol.10 (1), p.20005, Article 20005</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kurth, Mary Jo</au><au>McBride, William T.</au><au>McLean, Gavin</au><au>Watt, Joanne</au><au>Domanska, Anna</au><au>Lamont, John V.</au><au>Maguire, Daniel</au><au>Fitzgerald, Peter</au><au>Ruddock, Mark W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute kidney injury risk in orthopaedic trauma patients pre and post surgery using a biomarker algorithm and clinical risk score</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><stitle>SCI REP-UK</stitle><addtitle>Sci Rep</addtitle><date>2020-11-17</date><risdate>2020</risdate><volume>10</volume><issue>1</issue><spage>20005</spage><pages>20005-</pages><artnum>20005</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Acute kidney injury (AKI) after major trauma is associated with increased mortality. The aim of this study was to assess if measurement of blood biomarkers in combination with clinical characteristics could be used to develop a tool to assist clinicians in identifying which orthopaedic trauma patients are at risk of AKI. This is a prospective study of 237 orthopaedic trauma patients who were consecutively scheduled for open reduction and internal fixation of their fracture between May 2012 and August 2013. Clinical characteristics were recorded, and 28 biomarkers were analysed in patient blood samples. Post operatively a combination of H-FABP, sTNFR1 and MK had the highest predictive ability to identify patients at risk of developing AKI (AUROC 0.885). Three clinical characteristics; age, dementia and hypertension were identified in the orthopaedic trauma patients as potential risks for the development of AKI. Combining biomarker data with clinical characteristics allowed us to develop a proactive AKI clinical tool, which grouped patients into four risk categories that were associated with a clinical management regime that impacted patient care, management, length of hospital stay, and efficient use of hospital resources.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>33203963</pmid><doi>10.1038/s41598-020-76929-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8566-3572</orcidid><orcidid>https://orcid.org/0000-0002-9839-134X</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | 692/308 692/4022 692/420 692/499 692/53 Acute Kidney Injury - diagnosis Acute Kidney Injury - etiology Age Factors Aged Aged, 80 and over Biomarkers Biomarkers - blood Blood Dementia Dementia disorders Fatty Acid Binding Protein 3 - blood Fatty acid-binding protein Female Health risks Humanities and Social Sciences Humans Hypertension Kidneys Male Midkine - blood multidisciplinary Multidisciplinary Sciences Musculoskeletal Diseases - complications Orthopedics Patients Perioperative Care - methods Predictive Value of Tests Prospective Studies Risk Factors Science Science & Technology Science & Technology - Other Topics Science (multidisciplinary) Surgery Trauma Trauma centers Tumor Necrosis Factor-alpha - blood Wounds and Injuries - blood Wounds and Injuries - complications Wounds and Injuries - surgery |
title | Acute kidney injury risk in orthopaedic trauma patients pre and post surgery using a biomarker algorithm and clinical risk score |
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