SAT-168 PREVALENCE AND OUTCOMES OF ACUTE KIDNEY INJURY IN BURNS PATIENTS IN SOUTH AUSTRALIA

Abstract

Acute kidney injury (AKI) in severely burned patients are associated with significance morbidity and mortality. Generally, the incidence of AKI is 30% with up to 80% mortality following severe burn. The causes of AKI in burn are multi factorial with notable difference between early and late AKI. Early identification and recognition of patients at risk are the key factors for the correct fluid and volume resuscitations. The Burns Unit will begin fluid resuscitation for burns of TBSA >15%. The aim of this study is to ascertain AKI prevalence and ultimately long term kidney functions in the burn population of TBSA >15%. This is a retrospective study recruited all patients with burns with TBSA >15% admitted to Burns Unit Royal Adelaide Hospital from 2009 to 2013. Exclusion criterion included TBSA < 15%, no documented TBSA and no serum creatinine during admissions or discharge. A total of 132 admissions following burn injury from 2009 till 2013 and severe burns were documented in 77 patients. 10 were excluded as there were missing serum creatinine results. The baseline characteristics are documented in Table 1. Prevalence of AKI among burn patients was as high at 61%.Tabled 1Table 1: Baseline characteristics of patients with severe burn patientsn (%), mean ± SDAKI (n= 41)No AKI (n=26)p-valueAge44.56 ±17.4744.42 ±16.130.969Male33 (80.5%)19 (73.1%)Co-morbiditiesDiabetesHypertensionCKD3 (7.3%)5 (12.2%)1 (2.4%)4 (15.4%)2 (7.7%)0 (0%)TBSA %39.07 ± 17.1027.13 ± 10.61< 0.05Serum creatinine on admission99.05 ± 28.5865.35 ± 15.99< 0.05Serum creatinine at discharge79.93 ± 78.7258.73 ± 15.310.101Days of Admission38.29 ± 39.1725.51 ± 32.950.156Hours in ICU(Days)211.46 ± 292.25(8.8 days)32.72 ± 90.64(1.4 days)< 0.05Mortality6 (0.15%)0 (0%) Open table in a new tab Among those who had AKI, 90.24% presented as early AKI. Mean creatinine at 5 years among available patients was 91.85 ± 50.51 mmol/L. Early surgical management and adequate volume resuscitations are important in acute severe burns patients to ensure good clinical outcome. Severe burn patients who suffered AKI had significantly higher serum creatinine on admission, larger TBSA as well as had to spend longer in ICU as compared to patients without AKI. The mortality rate was 0.15% and exclusively occurred among patients who had AKI.