Abstracts from the 5th International Symposium on Acute Kidney Injury in Children

Background: Acute Kidney Injury (AKI) increases morbidity and mortality, but data in pediatric trauma are limited.We examined AKI incidence, kidney replacement therapy (KRT) use, and associated risk factors in this population.Methods: We studied pediatric patients (<18 years) within the Trauma Quality Improvement Program (TQIP) database from 2017-2023.We constructed multivariable logistic regression (MVLR) models to test for associations and adjust for confounders.AKI is defined as KDIGO stage 3 AKI or higher.Serious injury was defined as an abbreviated injury scale (AIS) of 3 for each body region.Results: Among 867,467 pediatric trauma cases that met inclusion, 510 developed AKI.Compared to children without AKI, children with AKI had significantly higher median composite injury severity scores (4 versus 26, p<0.001) and significantly lower survival, (98% versus 69%, p<0.001).In the MVLR model, older children, male sex (OR 1.20, 95% CI: 0.97-1.49.97.49), serious injury to the head/neck (3.48, 2.84-4.28.84.28), thorax (2.50, 2.00-3.11.00.11), abdomen (5.90, 4.79-7.28),extremities (2.26, 1.84-2.79.84.79) and skin (3.16, 2.14-4.68.14.68), in-hospital cardiac arrest (8.18, 6.24-10.72.24.72), pulmonary embolism (3.88, 1.97-7.66.97.66), sepsis (36.32, 23.83-55.37.83.37), ventilator-associated pneumonia (3.10, 1.96-4.91.96.91), acute respiratory distress syndrome (1.73, 1.03-2.89.03.89), and extracorporeal support (9.34, 5.51-15.85.51.85) were all associated with AKI.KRT use occurred in 20% of those with AKI.Conclusions: AKI was rare in this pediatric trauma population.Abdominal and head/neck injuries were most associated with AKI.When AKI occurred, it was frequently associated with other deleterious events and mortality was high.