Zeitschrift für Trauma und Behandlung

Acute Kidney Injury in Elderly Trauma: Not Associated with Admission IV Contrast

Abstract

Douglas Z. Liou, Cherisse Berry, Matthew B. Singer1, Steven Rudd, Sam S. Torbati, Paul A. Silka2, Marko Bukur, Ali Salim1 and Eric J. Ley1

Background: Given the decline of kidney function with advanced age, we evaluated the association between admission CT with IV contrast and acute kidney injury (AKI) in trauma patients older than 70 years.

Methods: A retrospective study was performed at an urban, academic Level I trauma center from January 1, 2006 to December 31, 2010. Trauma patients older than 70 years with available serum creatinine at admission and 48 to 72 hours post admission were included in the analysis. Patients who underwent an admission CT scan with IV contrast were compared to those who underwent admission CT without IV contrast. Mean creatinine levels and rate of AKI were compared. Stepwise logistic regression was performed to determine if IV contrast was an independent predictor of AKI.

Results: A total of 453 elderly patients met inclusion criteria with a mean age of 82.2 years and overall mortality of 13%. Patients who received IV contrast were younger (80.7 vs. 83.1 years, p<0.01), although had similar demographics and baseline characteristics. The rate of AKI in patients who received IV contrast was similar to the rate of those who did not (21.1% vs. 22.6%, p=0.73). Additionally, IV contrast with admission CT was not an independent predictor of developing AKI (AOR 1.2; CI 0.72-1.98; p=0.50).

Conclusion: Although a high ratio of elderly patients, approximately 1 in 5, was likely to develop AKI after trauma, this study demonstrates admission CT with IV contrast is not associated with AKI in trauma patients older than 70 years.