5317. Incidence of Contrast-Induced Acute Kidney Injury in Trauma Patients with Iso-Osmolar CT Contrast
Authors* Denotes Presenting Author
Jimi Huh *;
Ajou University Hospital
Kyungmin Lee;
Ajou University Hospital
Kyung Won Kim;
Asan Medical Center
Objective:
Iodixanol is a nonionic dimeric contrast agent with expected effect to reduce contrast-induced acute kidney injury (CI-AKI). In trauma patients, no report has been published on the preventive effect of iso-osmolar contrast agent for CI-AKI. Thus, we aimed to evaluate the incidence and severity of CI-AKI, and those predictive factors in trauma patients.
Materials and Methods:
From the institutional trauma registry in a regional trauma center of South Korea, patients were consecutively collected who underwent CT scan with iodixanol and followed up at least 72 hours after CT scan. Patient demographic details, comorbidities and laboratory test results were collected. CI-AKI was defined by the 2012 Kidney Disease Improving Global Outcomes (KDIGO) guideline. The severity of CI-AKI was classified by the RIFLE criteria. The severity of trauma was assessed by the injury severity score (ISS) category. The predictive factors of CI-AKI were evaluated by univariate and multivariate logistic regression.
Results:
Of 1115 patients who underwent CT with iodixanol, 799 with completed data were included in this study. The incidence of CI-AKI was 3.80% (30/799). Of these, severe renal failure according to RIFLE criteria occurred in 2.87% (23/799). The incidence of CI-AKI according to the ISS category were 1.52% (9/592) in minor group, 3.95% (7/177) in moderate group, 42.30% (11/26) in serious group, and 75.0% (3/4) in severe group. In univariate analysis, significant predictive factors of CI-AKI-based odds ratio OR included hypertension (2.87 [95% CI, 1.37 - 6.00]), heart disease (4.06 [95% CI, 1.32 - 12.42]), ISS serious category (47.50 [95% CI, 17.14 - 131.63]), and ISS severe category (194.33 [95% CI, 18.40 - 2052.06]). In multivariate analysis, significant predictive factors were ISS serious category (16.70 [95% CI, 16.70 - 138.96]), and ISS severe category (245.22 [95% CI, 21.88 - 2748.38]). In trauma patients who underwent CT with iodixanol, the incidence of CI-AKI of 3.8% was not high, but it largely relies on the severity of trauma.
Conclusion:
In trauma patients, the CT scans with iodixanol might be helpful to reduce the occurrence of CI-AKI.
