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首页> 外文期刊>South African medical journal = >Haemodialysis for post-traumatic acute renal failure - factors predicting outcome
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Haemodialysis for post-traumatic acute renal failure - factors predicting outcome

机译：血液透析治疗创伤后急性肾衰竭-预测预后的因素

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BACKGROUND: Post-traumatic acute renal failure requiring renal replacement therapy in an intensive care unit (ICU) is associated with high mortality. OBJECTIVE: To assess indicators of improved survival. METHODS: This was a retrospective cohort study of 64 consecutive trauma patients (penetrating and blunt trauma and burns) who underwent haemodialysis (HD) over a period of 5 years. Information on pre-hospital and in-hospital resuscitation, trauma scores and physiological scores and daily ICU records were collected. The majority of the patients were dialysed with continuous venovenous haemofiltration in the early years of the study and later with sustained low-efficiency dialysis. RESULTS: Of the 64 patients 47 died, giving an overall mortality rate of 73%. Mortality was highest in the burns patients (84%). Survival in all patients, irrespective of injury, was unrelated to the Revised Trauma Score, Injury Severity Score, Acute Physiology and Chronic Health Evaluation Score or Trauma Injury Severity Score. The duration of HD did not differ significantly between the three trauma groups, and age was not a significant predictor of survival. Patients who were polyuric at the time of the initiation of HD had a lower mortality rate than those who were oliguric, anuric or normouric, although this did not reach statistical significance (p=0.09). CONCLUSIONS: Acute renal failure in trauma patients is associated with a low survival rate. Controversial conclusions have been presented in the literature. In this study, none of the parameters previously reported to affect survival proved to be valid, although the number of patients was comparable with those in other studies. Since understanding of the predictors and course of renal failure in trauma patients is still at an early stage, there is a need for multicentre prospective studies.
机译：背景：需要在重症监护病房（ICU）进行肾脏替代治疗的创伤后急性肾衰竭与高死亡率相关。目的：评估改善生存的指标。方法：这是一项回顾性队列研究，研究对象为连续5年内接受血液透析（HD）的64例连续创伤患者（穿透性和钝性创伤及烧伤）。收集有关院前和院内复苏，创伤评分和生理评分以及每日ICU记录的信息。在研究的早期，大多数患者接受了连续静脉血液滤过的透析，随后进行了持续的低效率透析。结果：64例患者中有47例死亡，总死亡率为73％。烧伤患者的死亡率最高（84％）。所有患者的生存，不论是否受伤，均与经修订的创伤评分，损伤严重度评分，急性生理和慢性健康评估评分或创伤损伤严重度评分无关。在三个创伤组之间，HD的持续时间没有显着差异，并且年龄不是生存的重要预测指标。在开始HD时多尿的患者的死亡率要比少尿，无尿或正常尿的患者低，尽管这没有统计学意义（p = 0.09）。结论：创伤患者的急性肾衰竭与低存活率有关。文献中已经提出了有争议的结论。在这项研究中，尽管患者人数与其他研究相当，但先前报道的影响生存的参数均未证明是有效的。由于对创伤患者肾衰竭的预测因素和病程的了解仍处于早期阶段，因此需要进行多中心前瞻性研究。

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