Dr Samuel Sharp¹, Dr Lincoln Tracy^2,3, Ms Yvonne Singer^1,3, Mr Dane Holden^1,3, Dr Marc Schnekenburger¹, Dr Aidan Burrell¹, Dr Andrew Paton¹, Mr Stephen Salerno^1,3, Miss Heather Cleland^1,3

¹Alfred Health, Melbourne, Australia, ²Monash University, Clayton, Australia, ³Victorian Adult Burns Service, Melbourne, Australia

Abstract:

Background: Acute kidney injury (AKI) following burns is associated with increased mortality and morbidity (Palmieri, Lavrentieva & Greenhalgh 2010, Lopes et al. 2007, Kim et al. 2003, Coca et al. 2009), with some patients requiring renal replacement therapy (Palvesky 2013). There is limited large scale data to sufficiently validate the risk factors influencing the incidence and severity of early AKI. This study aimed at investigating the clinical characteristics and risk factors influencing the incidence and severity of early AKI in burns patients as well as in-hospital outcomes such as mortality.

Methods: Retrospective cohort data collected form BRANZ of adult patients admitted to a burns centre following a burn ≥10% Total body surface area (TBSA). AKI was determined using RIFLE criteria. All included patients required two valid serum creatinine blood tests within the first 72 hours. Data was analysed using logistic regression models.

Results: Between July 2016 and June 2021, 1,297 patient met inclusion criteria for this study. 83 patients (6.4%) developed early AKI. Patients with an AKI were older (p=0.008), had a greater median %TBSA burned (p<0.001), and had an inhalation injury (p<0.001). In adjusted models, development of early AKI resulted in a significant association with in-hospital mortality (p=0.002) and need for mechanical ventilation (p=0.001) but there was no significant increase in hospital length of stay (LOS) or Intensive care unit (ICU) LOS.

Conclusion: This is the first large scale study looking at early AKI in adult burns ≥ 10% TBSA. The incidence of AKI was lower than previously reported.  AKI was associated with higher in-hospital mortality and increased need for mechanical ventilation.

Biography:

Dr Samuel Sharp previously worked with the Victorian Adult Burns Service at Alfred Health as a Resident Medical Officer, gaining vast experience in the management and outcomes of burns patients.