AKI Linked to Mortality in Combat Injured

by U.S. Medicine

November 13, 2016

BETHESDA, MD—While acute kidney injury (AKI) has been associated with mortality after traumatic injury, little data exists on military servicemembers with combat injuries.

A study published recently in the American Journal of Kidney Diseases sought to identify risk factors for AKI after combat trauma and evaluate whether the condition is a predictor of mortality.1

For the retrospective observational study, Uniformed Services University of the Health Sciences-led researchers focused on 3,807 servicemembers who were critically wounded in Iraq or Afghanistan from Feb. 1, 2002, to Feb.1, 2011, and survived until evacuation to Landstuhl Regional Medical Center in Germany.

Measurements in the study included demographic variables, vital signs, injury severity score, presence of burn injury and mechanism of injury as defined at the time of initial injury, as well as AKI ascertained within the first seven days using KDIGO (Kidney Disease: Improving Global Outcomes) serum creatinine criteria.

With AKI occurring in 12.5% of patients and 2.9% of them dying, results indicate that more patients with AKI died than those without.

After adjustment, AKI was found to be a predictor of mortality with an odds ratio of 5.14. Older age, African-American race, injury severity score, amputations, burns and presenting vital signs were linked to increased risk for having acute kidney injury.

Taking the findings into account, study authors concluded that “AKI predicted mortality in combat veterans injured in the wars in Iraq and Afghanistan.”

  1. Stewart IJ, Sosnov JA, Howard JT, Chung KK. Acute Kidney Injury in Critically Injured Combat Veterans: A Retrospective Cohort Study. Am J Kidney Dis. 2016 Oct;68(4):564-70. doi: 10.1053/j.ajkd.2016.03.419. Epub 2016 May 5. PubMed PMID: 27155727.

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