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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Veröffentlicht in:Scientific reports 2020-11, Vol.10 (1), p.20005, Article 20005
Hauptverfasser: Kurth, Mary Jo, McBride, William T., McLean, Gavin, Watt, Joanne, Domanska, Anna, Lamont, John V., Maguire, Daniel, Fitzgerald, Peter, Ruddock, Mark W.
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container_title Scientific reports
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creator Kurth, Mary Jo
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Watt, Joanne
Domanska, Anna
Lamont, John V.
Maguire, Daniel
Fitzgerald, Peter
Ruddock, Mark W.
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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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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