Introduction: Acute kidney injury remains a major cause of morbidity and mortality among severely injured trauma patients, we sought to evaluate the association between major liver lacerations and acute kidney injury (AKI).
Methods: A retrospective analysis of patients admitted to our level 1 academic trauma center between July 2013 and July 2016 was conducted. Major liver laceration was identified from the trauma registry. AKI within the first seven days of admission was defined using KIDGO criteria. A logistic regression adjusted for age, sex, injury mechanism, and hypotension at admission. In a secondary analysis, models were stratified by whether the patient was admitted to the trauma intensive care unit (ICU).
Results: 15,395 patients were admitted to our trauma center, of those 227 had major liver laceration and 1,144 had acute kidney injury. Compared to trauma patients without a liver laceration, patients with a major liver laceration were twice as likely to have AKI within the first seven days of admission (OR 2.06, 95% CI 1.37-3.09). 80% of patients with major liver laceration were admitted to an ICU. When limiting the analysis to patients admitted to the ICU, there was no association between major liver laceration and AKI within the first seven days (OR 0.96, 95% CI 0.63-1.48).
Conclusion: Major liver laceration is associated with AKI in trauma patients not admitted to the ICU.
