Injury Criteria Research Articles

Accuracy of Instrumented Mouthguards During Direct Jaw Impacts Seen in Boxing.

Measuring head kinematics data is important to understand and develop methods and standards to mitigate head injuries in contact sports. Instrumented mouthguards (iMGs) have been developed to address coupling issues with previous sensors. Although validated with anthropomorphic test devices (ATDs), there is limited post-mortem human subjects (PMHS) data which provides more accurate soft tissue responses. This study evaluated two iMGs (Prevent Biometrics (PRE) and Diversified Technical Systems (DTS) in response to direct jaw impacts. Three unembalmed male cadaver heads were properly fitted with two different boil-and-bite iMGs and impacted with hook (4m/s) and uppercut (3m/s) punches. A reference sensor (REF) was rigidly attached to the base of the skull, impact kinematics were transformed to the head center of gravity and linear and angular kinematic data were compared to the iMGs including Peak Linear Acceleration, Peak Angular Acceleration, Peak Angular Velocity, Head Injury Criterion (HIC), HIC duration, and Brain Injury Criterion. Compared to the REF sensor, the PRE iMG underpredicted most of the kinematic data with slopes of the validation regression line between 0.72 and 1.04 and the DTS overpredicted all the kinematic data with slopes of the regression line between 1.4 and 8.7. While the PRE iMG was closer to the REF sensor compared to the DTS iMG, the results did not support the previous findings reported with use of ATDs. Hence, our study highlights the benefits of using PMHS for validating the accuracy of iMGs since they closely mimic the human body compared to any ATD's mandible.

Cognitive Assessment in Grappling Athletes Following Choke versus Nonchoke Submissions.

Participation in Brazilian jiu-jitsu and mixed martial arts has increased over the last three decades. These sports feature submission attacks, including strangles. These strangles, termed "chokes" in this context, primarily limit blood flow to the brain via compression of neck vasculature. There has been discussion in literature of the possibility of measurable cognitive effects following transient choking episodes. The present study used the King-Devick test (KDT) platform, a tablet-based reaction time and accuracy task designed to measure participants' number recognition, cognition, and verbal expression. This task requires functional vision, saccadic eye movements, comprehension, and expression. Volunteer participants were screened for exclusion (prior brain injury) criteria and survey information before testing. Athletes were tested with the KDT immediately before a Brazilian jiu-jitsu training session, again immediately after succumbing to either a choke ("Choke" arm) or nonchoke ("Non-Choke" arm) submission while sparring, and again after a 10-min rest period following the postsubmission test. Analysis was done on test failures, total test times, and individual difference scores between baseline and subsequent testing. Sixty-two (32 Choke, 30 Non-Choke) participants were analyzed. There was no significant difference between Choke and Non-Choke in test failures ( χ2 (1,62) = 1.25, P = 0.263), total times ( t (60) = 0.62, P = 0.540; 95% CI, -3.44 to 6.51), and individual difference scores ( t (60) = 0.29, P = 0.776; 95% CI, -2.41 to 3.21). There were no significant differences between study arms in any of the three analyzed measures. This suggests that cognitive functioning, as measured by the KDT, is not affected by transient choking episodes.

Effect of additively manufactured polymeric inserts on impact response of construction safety helmets

Purpose Struck-by accidents (i.e. being hit by a falling object) are a leading cause of traumatic brain injuries in the construction industry. Despite the critical role of hard hats in minimizing such injuries, their overall design has not appreciably changed in decades. Therefore, this study aims to explore the potential benefits of modifying commercially available hard hat designs by incorporating a compliant cantilever and a sacrificial, energy-absorbing structure to enhance their protective capabilities against impacts. Design/methodology/approach This study involved conducting experimental impact tests to obtain the head acceleration attenuation using hard hats with a variety of compliant cantilever lattice insert designs. These lattice inserts were additively manufactured using three polymeric materials, including polylactide (PLA), acrylonitrile butadiene styrene, high-impact polystyrene and three porosity levels. A Hybrid III head/neck assembly was fitted with each hard hat design, and experimental drop tests were conducted using a 1.8-kg steel impactor dropped from 1.83 m. The maximum acceleration and head injury criterion (HIC) values were obtained for each test. Findings Analysis of variance revealed that HIC was significantly reduced for all lattices with 56% porosity (p < 0.023) compared to the control (unmodified) hard hat. The most effective insert was found to be a PLA insert with 56% porosity, which reduced the HIC value by 38% compared to the control (unmodified) hard hat, with a statistically significant p-value of 0.018. Originality/value The data present in this study reveals that simple and inexpensive modifications can be made to existing hard hat designs to reduce injury risk from overhead impacts.

Energy-absorbing limitations of hard hat safety helmets in mitigating trauma from falling objects

The aim of the study was to analyze the effectiveness of hard hat helmets in mitigating head injuries from high-energy falling objects through a real-world case study, advanced numerical simulations and an uncertainty study. The study aims to answer the following research questions: (a) to what extent would the use of the protective helmet limit the kinetic energy of the falling construction prop, (b) whether the hard hat helmet would be damaged, and if so, to what extent, according to the helmet standards? A fatal construction accident involving a falling prop impact on the victim’s head was reconstructed using multi-body dynamics simulations and finite element analysis (FEA) based on uncertainty-based determination of initial conditions. The study quantified the impact energy, helmet damage and its energy-absorbing capabilities, and potential injury reduction compared to scenarios without a helmet. While the helmet absorbed significant energy (245% of the standard requirement) and reduced the Head Injury Criterion by 8–11%, the high impact energy ultimately proved fatal. This study highlights the limitations of hard hat helmets in extreme scenarios with high kinetic energy impacts. While helmets offer valuable protection, unrealistic expectations should not be placed on their ability to prevent all head injuries. The study not only enhances our understanding of the biomechanics of head injuries in such incidents but also provides practical implications for safety protocols and regulations.

Functionally graded foam materials for head impact protection

Head injuries commonly result from impact accidents, underscoring the urgent requirement for enhanced helmet protection. Functionally graded foam (FGF) materials present promising avenues for augmenting the design of impact-attenuating liners in helmets, thereby mitigating head injuries. This study aims to investigate the performance of the FGF materials in protecting against head impact and provide an effective optimization methodology to support the efficient and reliable design of the FGF materials. The foam finite element model was developed and coupled with a highly biofidelic head model to simulate the FGF-head frontal impact scenarios. A parametric study based on the coupled FGF-head model was conducted to explore the effects of the configuration parameters on the protection performance of the FGF materials. The study demonstrated that the negative-gradient FGF materials provide better head impact protection than the uniform density foam (UDF) and positive-gradient FGF materials, despite the potential disadvantage in energy absorption. A discrete optimization method based on the FGF-head model was developed and illustrated to efficiently achieve an optimized design for FGF protectability, thereby reducing the risk of head injuries. The optimized FGF design reduced the Head Injury Criterion (HIC) value by 40.4 % compared to the conventional UDF design, from 1660 to 990. Therefore, this study provides a further understanding and a new optimization insight into designing FGF materials to improve head impact protection.

Finite element modeling and injury criteria investigation for the lower leg of the Chinese human body under impact loads

The widely used human body injury criteria were established based on the biomechanical response of the Euro-American human body, without considering the difference in the body anthropometry and injury characteristics among different races, particularly the Chinese human body that has the smaller body size. The absence of such race specific design considerations negatively influences the injury prevention capability for these populations, and weakens the applicability of injury criteria. To resolve these issues, this study aim to develop a lower leg finite element model of a 50th percentile Chinese male. The model is built based on the medical images of an average size Chinese male with detailed ankle ligaments and lower leg muscles modeled. Sixty experiments available in the literature are used to validate its biofidelity. Using the validated model, the lower leg model is subjected to combined axial compression and bending loads to evaluate its injury criteria. Compared with a typical Euro-American human body mode, the Chinese lower leg presents lowered mechanical tolerance, and the revised tibia index may be an option to be the injury criteria for the Chinese lower leg. Additionally, the validated model reproduces the pedestrian lower leg fracture in a domestic accident.

A Case of Cardiac Surgery-Associated Acute Kidney Injury

Approximately 2 million patients undergo cardiac surgery annually with 20% to 30% developing the cardiac surgery-associated acute kidney injury. Patient who has undergone cardiac surgery in the past week and meets the criteria for acute kidney injury can be classified as a cardiac surgery-associated acute kidney injury. The cardiac surgery-associated acute kidney injury may be caused by various factors during perioperative period. Preoperative risk factors include advanced age, female gender, pre-existing renal insufficiency, heart failure, left main coronary artery disease, diabetes, chronic obstructive pulmonary disease, peripheral vascular disease, liver disease, low cardiac output and hypotension. Intraoperative risk factors include the type of surgery (valve surgery, combined valve and coronary artery surgery, emergency and reoperations), low-flow cardiopulmonary bypass, hypothermic cardiopulmonary bypass, deep hypothermic circulatory arrest, cardiopulmonary bypass duration >100-120 minutes, hemodilution, hemolysis and hemoglobinuria due to prolonged cardiopulmonary bypass duration. We present the case of a 53-year-old female with severe valvular heart disease complicated by infecting human immunodeficiency virus. She experienced an acute kidney injury after cardiac surgery. The rationale for this case report is to learn about the risk factors of cardiac surgery-associated acute kidney injury and take measures to prevent it.

Evaluation of a novel head and neck restraint for harness-restrained children

Motor Vehicle Crashes (MVCs) are a common source of neck injury and, although rare, catastrophic neck injury occurs in restrained children up to age 10 years old. Recently, a head/neck support (HNS) that cradles the head during sleep was developed. The objective of this study was to determine if the HNS improves injury criteria measured on anthropomorphic test devices (ATDs) in front facing 5-point harness child restraint systems (FFCRS). Nineteen matched pair frontal impact sled tests were conducted with ATDs representing the 12 month old, or 3 or 6 year old child in FFCRS. HNS reduced HIC36 by median 22.2%, maximum resultant head acceleration (3ms clip) by 16.2%, head excursion by 8.2%, and neck tension by 12.2%. Providing supplemental restraint directly to the head has the potential to improve injury outcomes while not adding to harm during common misuse scenarios, but further research is needed to determine if these benefits persist in real-world crashes.

Analysis of Injury Metrics From Experimental Cardiac Injuries From Behind Armor Blunt Trauma Using Live Swine Tests: A Pilot Study.

Warfighters are issued hard body armor designed to defeat ballistic projectiles. The resulting backface deformation can injure different thoracoabdominal organs. Developed over decades ago, the behind armor blunt impact criterion of maximum 44 mm depth in clay continues to be used independent of armor type or impact location on the thoracoabdominal region covered by the armor. Because thoracoabdominal components have different energy absorption capabilities, their mode of failures and mechanical properties are different. These considerations underscore the lack of effectiveness of using the single standard to cover all thoracoabdominal components to represent the same level of injury risk. The objective of this pilot study is to conduct cardiac impact tests with a live animal model and analyze biomechanical injury candidate metrics for behind armor blunt trauma applications. Live swine tests were conducted after obtaining approvals from the U.S. DoD. Trachea tubes. An intravenous line were introduced into the swine before administering anesthesia. Pressure transducers were inserted into lungs and aorta. An indenter simulating backface deformation profiles produced by body armor from military-relevant ballistics to human cadavers delivered impact to the heart region. The approved test protocol included 6-hour monitoring and necropsies. Indenter accelerometer signals were processed to compute the velocity and deflection, and their peak magnitudes were obtained. The deflection-time signal was normalized with respect to chest depth along the impact axis. The peak magnitude of the viscous criterion, kinetic energy, force, momentum and stiffness were obtained. Out of the 8 specimens, 2 were sham controls. The mean total body mass and soft tissue thickness at the impact site were 81.1 ± 4.1 kg and 3.8 ± 1.1 cm. The peak velocities ranged from 30 to 59 m/s, normalized deflections ranged from 15 to 21%, and energies ranged from 105 to 407 J. The range in momentum and stiffness were 7.0 to 13.9 kg-m/s and 22.3 to 79.9 N/m. The maximum forces and impulse data ranged from 2.9 to 11.7 kN and 1.9 to 5.8 N-s. The peak viscous criterion ranged from 2.0 to 5.3 m/s. One animal did not sustain any injuries, 2 had cardiac injuries, and others had lung and skeletal injuries. The present study applied blunt impact loads to the live swine cardiac region and determined potential candidate injury metrics for characterization. The sample size of 6 swine produced injuries ranging from none to pure skeletal to pure organ trauma. The viscous criterion metric associated with the response of the animal demonstrated a differing pattern than other variables with increasing velocity. These findings demonstrate that our live animal experimental design can be effectively used with testing additional samples to develop behind armor blunt injury criteria for cardiac trauma in the form of risk curves. Injury criteria obtained for cardiac trauma can be used to enhance the effectiveness of the body armor, reduce morbidity and mortality, and improve warfighter readiness in combat operations.

Effects of different seat inclination angles on lumbar dynamic response and injury during lunar-earth reentry.

The inclination angle of the spacecraft seat is related to the astronaut's reentry angle, which in turn affects the safety of the astronauts. This study quantitatively analyzed the effects of different seat inclination angles on astronauts' lumbar spine injuries using the finite element method during the Lunar-Earth reentry. Firstly, a finite element model of the astronaut's lumbar spine was constructed based on reverse engineering technology, and the effectiveness of the model was verified through mesh sensitivity, vertebral range of motion, and spinal impact experiments. Then, simulation calculations were carried out for different seat inclination angles (0°, 10°, 20°, and 30°) under the typical reentry return loads of Chang'e 5T1 (CE-5T1) and Apollo 10, and the prediction and evaluation of lumbar spine injuries were conducted in conjunction with the biological tissue injury criteria. The results indicated that the stress on the vertebrae and annulus fibrosus increased under both reentry loads with the rise of the seat inclination angle, but the increasing rates decreased. When the acceleration peak of CE-5T1 approached 9G, the risk of tissue injury was higher under the seat angle exceeded 20°. According to the Multi-Axis Dynamic Response Criteria for spinal injury, neither of the two load conditions would directly cause injury to the astronauts' lumbar spine when the seat inclination angle was below 30°. The study findings provide a numerical basis for designing and improving the spacecraft's inclination angle in crewed lunar missions, ensuring the safety of astronauts.

On the design of vehicle front-ends for pedestrian safety with the advanced Pedestrian Legform Impactor (aPLI)

The latest Euro NCAP Vulnerable Road Users Assessment Protocol (v11.3) introduces the advanced Pedestrian Legform Impactor (aPLI) to reduce the risk of lower extremity injury to pedestrians in a vehicle collision. The addition of femur injury criteria and the added simplified upper body mass, compared to its predecessor –the FlexPLI–, allows a more comprehensive assessment of passive pedestrian safety. However, this presents new challenges for vehicle manufacturers as these additions must be accounted for. We perform four sensitivity analyses at two test positions (centre and at the headlight) on two vehicles (compact car and SUV). Thereby, we investigate five design parameters that represent the main front-end components and identify that the vehicle type determines the sensitive design parameters significantly. Furthermore, we show that the influence of the lower stiffener and energy-absorbing foam diminishes compared to older legform impactors, while that of the bonnet increases.

Matched-pair hybrid test paradigm for behind armor blunt trauma using an experimental animal model

BackgroundThe current behind armor blunt trauma (BABT) injury criterion uses a single penetration limit of 44 mm in Roma Plastilina clay and is not specific to thoracoabdominal regions. However, different...

Simulation for fuselage section with dummies and seats under crash environment

Abstract A numerical model of a commercial fuselage section with dummies and seats under a crash environment was investigated to evaluate the dynamic responses of occupants. Firstly, the two dynamic tests about seats and occupants restraint system were performed to meet the requirements specified by CCAR-25, including the tension loads in straps and the head injury criterion, and gained a method for simulation on seats and occupants restraint system. Secondly, the detail fuselage FE model was built to compare different vertical velocities; the results showed that the greater the velocity is, the more violently the dummies moved, while the deformation of structures had no difference.

Biological effects of corticosteroids on pneumococcal pneumonia in Mice—translational significance

BackgroundStreptococcus pneumoniae is the most common bacterial cause of community acquired pneumonia and the acute respiratory distress syndrome (ARDS). Some clinical trials have demonstrated a beneficial effect of corticosteroid therapy in community acquired pneumonia, COVID-19, and ARDS, but the mechanisms of this benefit remain unclear. The primary objective of this study was to investigate the effects of corticosteroids on the pulmonary biology of pneumococcal pneumonia in a mouse model. A secondary objective was to identify shared transcriptomic features of pneumococcal pneumonia and steroid treatment in the mouse model and clinical samples.MethodsWe carried out comprehensive physiologic, biochemical, and histological analyses in mice to identify the mechanisms of lung injury in Streptococcus pneumoniae with and without adjunctive steroid therapy. We also studied lower respiratory tract gene expression from a cohort of 15 mechanically ventilated patients (10 with Streptococcus pneumoniae and 5 controls) to compare with the transcriptional studies in the mice.ResultsIn mice with pneumonia, dexamethasone in combination with ceftriaxone reduced (1) pulmonary edema formation, (2) alveolar protein permeability, (3) proinflammatory cytokine release, (4) histopathologic lung injury score, and (5) hypoxemia but did not increase bacterial burden. Transcriptomic analyses identified effects of steroid therapy in mice that were also observed in the clinical samples.ConclusionsIn combination with appropriate antibiotic therapy in mice, treatment of pneumococcal pneumonia with steroid therapy reduced hypoxemia, pulmonary edema, lung permeability, and histologic criteria of lung injury, and also altered inflammatory responses at the protein and gene expression level. The transcriptional studies in patients suggest that the mouse model replicates some of the features of pneumonia in patients with Streptococcus pneumoniae and steroid treatment. Overall, these studies provide evidence for the mechanisms that may explain the beneficial effects of glucocorticoid therapy in patients with community acquired pneumonia from Streptococcus Pneumoniae.

Gentamicin concentration and acute kidney injury in term neonates treated for neonatal sepsis with gentamicin and ampicillin-cloxacillin combination.

Gentamicin is widely used to treat neonatal infections caused by both Gram-negative and Gram-positive bacteria, and the WHO recommends its use while monitoring serum creatinine and gentamicin concentrations to avoid drug-induced nephrotoxicity and ototoxicity. Yet in some resource-limited settings, the drug is used without monitoring. A population pharmacokinetics study involving term neonates with neonatal infection admitted to a neonatal unit. Participants were started on intravenous gentamicin 5 mg/kg once a day in combination with ampicilin-cloxacillin. Blood samples for serum gentamicin concentration were taken at 0.25, 0.5, 1, 2, 3, 5, 6, 8, 10, 12, 14, 16, 18, 20, 23, and 24 hours after the initial dose, each participant contributing two samples to the 24 hour sampling schedule. An additional sample for trough concentration was taken from each participant just before the third gentamicin dose while serum creatinine concentration was measured before and after treatment. Twenty-four participants were enrolled into the study and included in the final analysis. Mean (SD) peak and trough serum gentamicin concentrations were 16.66 (0.64) µg/mL and 3.28 (0.70) µg/mL, respectively. Gentamicin clearance (CL) was 0.40 mL min-1 kg-1 and volume of distribution (VD) was 0.31 L kg-1. Mean (SD) serum creatinine level after treatment was 209.7 (70.4) µmol/L compared to 103.3 (23.6) µmol/L before treatment [mean difference (106.4 ± 67.1; 95% confidence interval (CI): 78.1; 134.7 µmol/L; t (23) = 7.77; P < 0.001]. All participants fulfilled the Kidney Disease Improving Global Outcomes (KDIGO) criteria for acute kidney injury after treatment. Treatment of neonatal infection with antimicrobial regimen containing gentamicin, without renal function and gentamicin concentration monitoring, carries a significant risk for drug-induced acute kidney injury.

The dynamic response of human lungs due to underwater shock wave exposure.

Since the 19th century, underwater explosions have posed a significant threat to service members. While there have been attempts to establish injury criteria for the most vulnerable organs, namely the lungs, existing criteria are highly variable due to insufficient human data and the corresponding inability to understand the underlying injury mechanisms. This study presents an experimental characterization of isolated human lung dynamics during simulated exposure to underwater shock waves. We found that the large acoustic impedance at the surface of the lung severely attenuated transmission of the shock wave into the lungs. However, the shock wave initiated large bulk pressure-volume cycles that are distinct from the response of the solid organs under similar loading. These pressure-volume cycles are due to compression of the contained gas, which we modeled with the Rayleigh-Plesset equation. The extent of these lung dynamics was dependent on physical confinement, which in real underwater blast conditions is influenced by factors such as rib cage properties and donned equipment. Findings demonstrate a potential causal mechanism for implosion injuries, which has significant implications for the understanding of primary blast lung injury due to underwater blast exposures.

Crashworthiness investigation on a Carbon Fiber Reinforced Plastic solar vehicle

This article presents a research study involving different simulations of crash tests by means of the finite element explicit dynamic software Ansys LS-Dyna to determine the roadworthiness of a fully composite chassis lightweight solar vehicle and its conformity to the World Solar Challenge (WSC) regulations. Furthermore, the paper describes the results of crash test simulations in conditions comparable with those of the standard homologation test, with an initial velocity of 15.5 m/s against a rigid barrier considering overlaps of 50% and 100%. The velocity measured at the base of the seat was later used in a sled test with a dummy to calculate the Head Injury Criterion (HIC), a number proportional to the probability of head injury caused by the impact. The values remained within the threshold of acceptability with overlap at 50% but exceeded the limit with the 100% overlap. With no load limiter implemented in the model, the seatbelt caused contact forces with the chest up to 14 kN against 6 kN of the typical load limiter used in road cars to limit damage to ribs and internal organs. Finally, the possibility of improving the front crash box was investigated by changing the crash box’s planar sandwich structure with corrugated ones and layup without foam between the carbon layers. Various values of semi-amplitudes (A) of the sinusoidal profile have been tested. With a value of A of 6 mm, the capacity to absorb energy from an impact at 9 m/s was close to the original configuration.

Region specific anisotropy and rate dependence of Göttingen minipig brain tissue.

Traumatic brain injury is a major cause of morbidity in civilian as well as military populations. Computational simulations of injurious events are an important tool to understanding the biomechanics of brain injury and evaluating injury criteria and safety measures. However, these computational models are highly dependent on the material parameters used to represent the brain tissue. Reported material properties of tissue from the cerebrum and cerebellum remain poorly defined at high rates and with respect to anisotropy. In this work, brain tissue from the cerebrum and cerebellum of male Göttingen minipigs was tested in one of three directions relative to axon fibers in oscillatory simple shear over a large range of strain rates from 0.025 to 250s-1. Brain tissue showed significant direction dependence in both regions, each with a single preferred loading direction. The tissue also showed strong rate dependence over the full range of rates considered. Transversely isotropic hyper-viscoelastic constitutive models were fit to experimental data using dynamic inverse finite element models to account for wave propagation observed at high strain rates. The fit constitutive models predicted the response in all directions well at rates below 100s-1, after which they adequately predicted the initial two loading cycles, with the exception of the 250s-1 rate, where models performed poorly. These constitutive models can be readily implemented in finite element packages and are suitable for simulation of both conventional and blast injury in porcine, especially Göttingen minipig, models.

Numerical and theoretical investigation of crack propagation in the windshield in collision with a dummy headform

Studies show that the impact of the pedestrian head and windshield is a significant contributing factor to casualties in traffic accidents. Accordingly, investigating the mechanical response of the windshield and its failure mechanism is of significant importance in enhancing the safety of pedestrians in car accidents. This study conducted the pedestrian protection head impact test to determine the fracture mode of the windshield, acquire the acceleration curve of the headform impactor, and accurately obtain the peak acceleration and Head Injury Criterion (HIC). Subsequently, to quickly predict HIC and facilitate structural selection in designing automobiles, a theoretical analysis model for predicting peak acceleration was established and validated against the test results. To analyze the damage mechanism in detail, finite element analysis software LS-DYNA was employed to simulate the crack propagation in the windshield based on the peridynamics theory. Through a comparison between the numerical simulation and experimental results, the accuracy of the bond-based peridynamics model was verified, accurately revealing its failure mode and mechanical response to impact. Meanwhile, the peak acceleration and HIC were effectively predicted, which provided an effective approach for vehicle safety evaluation and design.

Correlation of Peripartum Acute Kidney Injury Severity With Obstetric Comorbidity Index Scores and Maternal Morbidity [ID 2683636

INTRODUCTION: Risk stratification systems are increasingly used to predict obstetric complications. The Obstetric Comorbidity Index (OB-CMI) is one validated prediction tool, applying weighted scores to maternal and obstetric conditions. Although acute kidney injury (AKI) is a severe maternal morbidity, there is limited information on predicting AKI severity. We aimed to investigate the utility of OB-CMI scores and its specific comorbidities in predicting obstetric AKI severity, and the relationship of AKI severity and other maternal morbidity outcomes. METHODS: This was an IRB-exempt, retrospective cohort study of AKI cases (ICD-10 code N17.0-17.9) between January 2018 and December 2022 at a single academic institution with ∼6,000 births annually. Information was extracted via chart review. Cases were stratified by those meeting American College of Obstetricians and Gynecologists (ACOG)/Society for Maternal-Fetal Medicine (SMFM) criteria for severe renal injury. Those with unknown baseline Cr were assigned 0.7 (the 95th percentile Cr value at 39–40 weeks). Groups were compared based on admission OB-CMI scores and comorbidities, and maternal morbidity events using independent t-tests, χ2, and Fisher's exact as appropriate. RESULTS: Two hundred thirty cases were reviewed: 8.3% (19 cases) met ACOG/SMFM AKI criteria. There was no significant difference in mean OB-CMI scores (mean 3.8 versus 4.1; P=.782) or incidence of individual comorbidities between groups. Regarding other maternal morbidity events, ACOG/SMFM criteria AKI was significantly associated with other severe morbidity events (47.4% versus 12.3%; P&lt;.001), including transfusion, disseminated intravascular coagulation, intubation, and intensive care unit admission. CONCLUSION: The OB-CMI score was poorly predictive of AKI severity; however, the occurrence of severe AKI by ACOG/SMFM criteria was associated with a 4-fold increased rate of co-occurring maternal morbidity events and a 2.5-fold increased rate of blood transfusion.