Incidence of, Risk Factors for, and Mortality Associated with Severe Acute Kidney Injury after Gunshot Wound

Abstract

Importance: Acute kidney injury increases the risk of mortality in hospitalized patients. However, incidence of severe acute kidney injury (SAKI) and its association with mortality in civilians with gunshot wounds (GSWs) is not known. Objective: To determine the incidence of and risk factors associated with SAKI and acute kidney injury requiring dialysis (AKI-D) after GSWs and the association of SAKI and AKI-D with mortality among civilians in the United States. Design, Setting, and Participants: This retrospective cross-sectional study included civilians with GSW reported to the National Trauma Data Bank between July 1, 2010, and June 30, 2015. Torso GSWs were included in study; GSWs to the head were excluded. The data were analyzed between September and November 2018. Exposure: Civilians with GSW. Main Outcomes and Measures: Incidence of SAKI and AKI-D; association of SAKI and AKI-D with mortality. Results: Most of the 64059 civilian GSWs affected men (57431 [89.7%]) and racial/ethnic minorities (36205 [56.5%] African American individuals; 9681 [15.1%] Hispanic individuals). Incidence of SAKI was 2.3% (1450 of 64059), and incidence of AKI-D was 0.9% (588 of 64059). On multivariate analysis, SAKI was associated with older age (odds ratio [OR], 1.02; 95% CI, 1.01-1.02; P