POS-007 ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II (APACHE II) SCORING IS A PREDICTOR FOR ACUTE KIDNEY INJURY IN POLYTRAUMA PATIENTS

Abstract

Trauma patients are at risk of acute kidney injury (AKI), which may be explained by renal hypoperfusion, rhabdomyolysis, direct renal injury, or the nephrotoxic effects of therapies in these patients, who survive their initial injuries and are associated with poor outcomes and higher mortality rates. The current study aimed to identify the predictors of AKI in polytrauma patients to prevent its occurrence and to improve the management of those critical patients. This is a prospective observational and analytical study. It was conducted on 300 polytrauma patients in Mansoura University Emergency Hospital (MUEH), Egypt, with the exclusion of diabetic and chronic kidney disease patients. APACHE II, Glasgow Coma Score (GCS), and Injury Severity Score (ISS) were evaluated with other routine laboratory data for every patient. Serum creatinine was repeated every 24 hours to assess the presence of AKI and determine the stage according to AKIN criteria. The frequency of AKI development among the polytrauma patients was (23.7%); including 50.7% with stage 1 AKI; 32.4% with stage 2 AKI and 16.9% with stage 3 AKI. Univariate analysis showed that low GCS, high ISS, high APACHE II score, high initial lactate, and high initial serum creatinine were risk factors for AKI in trauma patients. While multivariate analysis revealed only APACH II risk stratification scoring and the initial serum creatinine at admission were independent predictors for AKI development in polytrauma patients. Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring and initial serum creatinine are predictors for acute kidney injury in polytrauma patients.