Athavale et al identified risk factors for severe acute kidney injury (SAKI) after a civilian gunshot wound. SAKI is associated with increased mortality compared to patients without it. The authors are from John H. Stroger Jr Hospital of Cook County (Chicago) and Chang Gung University (Taiwan).
Patient selection: civilian gunshot wound
Risk factors for severe acute kidney injury from a multivariate analysis:
(1) older age (odds ratio 1.02)
(2) male sex (odds ratio 1.4)
(3) diabetes (odds ratios 1.6)
(4) hypertension (odds ratio 1.8)
(5) low Glasgow Coma Score (odds ratio 0.98)
(6) sepsis (odds ratio 13.8)
(7) hollow viscus injury (odds ratio 2.3)
(8) urinary tract injury (odds ratio 2.2; ? gunshot to kidney)
(9) higher injury severity score (odds ratio 1.02)
These may be viewed as reflecting more severe injury, greater comorbidity and significant complications.
Mortality was greatest for patients who required dialysis (28%), followed by SAKI (20%), versus neither (9%).
