Computed tomography scans with intravenous contrast: low incidence of contrast-induced nephropathy in blunt trauma patients

Computed tomography scans with intravenous contrast: low incidence of contrast-induced nephropathy in blunt trauma patients

Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of the blunt trauma patient; however, the risk for contrast-induced nephropathy (CIN) in these patients still remains unclear. The goal of this study was to describe the rate of CIN in blunt trauma patient...

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Published in:The journal of trauma and acute care surgery Vol. 77; no. 2; pp. 226 - 230
Main Authors: Colling, Kristin P, Irwin, Eric D, Byrnes, Matthew C, Reicks, Patricia, Dellich, Wendy A, Reicks, Kyle, Gipson, Jonathan, Beilman, Greg J
Format: Journal Article
Language:English
Published: United States 01-08-2014
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Contrast Media - adverse effects
Creatinine - blood
Diabetes Complications - epidemiology
Female
Humans
Incidence
Infant
Kidney Diseases - chemically induced
Kidney Diseases - epidemiology
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed - adverse effects
Tomography, X-Ray Computed - methods
Wounds, Nonpenetrating - diagnostic imaging
Young Adult
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Summary:Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of the blunt trauma patient; however, the risk for contrast-induced nephropathy (CIN) in these patients still remains unclear. The goal of this study was to describe the rate of CIN in blunt trauma patients at a Level 1 trauma center and identify the risk factors of developing CIN. After internal review board approval, we reviewed our Level 1 trauma registry to identify blunt trauma patients admitted during a 1-year period. Chart review was used to identify patient demographics, creatinine levels, and vital signs. CIN was defined as an increase in creatinine by 0.5 mg/dL from admission after undergoing CT with IV contrast. Four percent of patients developed CIN during their admission following receipt of IV contrast for CT; 1% had continued renal impairment on discharge. No patients required dialysis during their admission. Diabetic patients had an increased rate of CIN, with 10% rate of CIN during admission and 4% at discharge. In multivariate analysis, only preexisting diabetes and Injury Severity Score (ISS) of greater than 25 were independently associated with risk for CIN. The rate of CIN in trauma patients following CT scan with IV contrast is low. Diabetes and ISS were independent risk factors of development of CIN in trauma patients. Epidemiologic/prognostic study, level III.
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ISSN:2163-0755
2163-0763
DOI:10.1097/TA.0000000000000336