Defining incidence and outcome of contrast-induced nephropathy among trauma

Is it overhyped?

Narong Kulvatunyou, Peter M Rhee, Steven N. Carter, Pamela M. Roberts, Jason S. Lees, Jeffrey S. Bender, Roxie M. Albrecht

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Contrast-induced nephropathy (CIN) in trauma patients is uncommon and the incidence is unknown. We studied the incidence of CIN and its outcome. A retrospective chart review of trauma patients 16 years of age and older who were admitted to our Level I trauma center during 2005 was performed. Patients who received the intravenous contrast CT scan and had their serum creatinine (Cr) monitored at admission and at 48 to 72 hours were identified. CIN was defined as a 0.5-mg/dL rise of serum Cr or a 25 per cent increase from the baseline if the baseline Cr was abnormal. We excluded patients transferred from an outside facility, patients without repeated serum Cr measurements, patients who had cardiac arrest or persistent hypotension, and patients who had received N-acetylcysteine (Mucomyst) before their CT scan. We compared CIN and non-CIN groups. During 2005, 543 fit our study criteria, of whom 19 (3.5%) had CIN. CIN (vs non-CIN) had a higher baseline serum Cr (1.48 1 0.23 vs 1.06 1 0.02, P < 0.001), a longer intensive care unit stay (17 vs 5 days, P < 0.001), and a longer hospital stay (19 vs 8 days, P < 0.001); the mortality rate was not different (10 vs 4%, P = 0.2). We found elevated baseline serum Cr (OR, 1.92; 95% CI, 1.13 to 3.27; P = 0.016) to be associated with increased risk for CIN. All but two serum Cr levels peaked within 48 hours; all returned to baseline. One patient with an underlying congenital kidney disease required temporary dialysis. CIN incidence in trauma is low and the clinical course is benign.

Original languageEnglish (US)
Pages (from-to)686-689
Number of pages4
JournalAmerican Surgeon
Volume77
Issue number6
StatePublished - Jun 2011

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Creatinine
Incidence
Wounds and Injuries
Serum
Acetylcysteine
Trauma Centers
Kidney Diseases
Heart Arrest
Hypotension
Intensive Care Units
Dialysis
Length of Stay
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Kulvatunyou, N., Rhee, P. M., Carter, S. N., Roberts, P. M., Lees, J. S., Bender, J. S., & Albrecht, R. M. (2011). Defining incidence and outcome of contrast-induced nephropathy among trauma: Is it overhyped? American Surgeon, 77(6), 686-689.

Defining incidence and outcome of contrast-induced nephropathy among trauma : Is it overhyped? / Kulvatunyou, Narong; Rhee, Peter M; Carter, Steven N.; Roberts, Pamela M.; Lees, Jason S.; Bender, Jeffrey S.; Albrecht, Roxie M.

In: American Surgeon, Vol. 77, No. 6, 06.2011, p. 686-689.

Research output: Contribution to journalArticle

Kulvatunyou, N, Rhee, PM, Carter, SN, Roberts, PM, Lees, JS, Bender, JS & Albrecht, RM 2011, 'Defining incidence and outcome of contrast-induced nephropathy among trauma: Is it overhyped?', American Surgeon, vol. 77, no. 6, pp. 686-689.
Kulvatunyou N, Rhee PM, Carter SN, Roberts PM, Lees JS, Bender JS et al. Defining incidence and outcome of contrast-induced nephropathy among trauma: Is it overhyped? American Surgeon. 2011 Jun;77(6):686-689.
Kulvatunyou, Narong ; Rhee, Peter M ; Carter, Steven N. ; Roberts, Pamela M. ; Lees, Jason S. ; Bender, Jeffrey S. ; Albrecht, Roxie M. / Defining incidence and outcome of contrast-induced nephropathy among trauma : Is it overhyped?. In: American Surgeon. 2011 ; Vol. 77, No. 6. pp. 686-689.
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