Evidence map›Paper›PMID 34711197›Full record

Observational studyBMC nephrology2021

High risk of acute kidney injury in Malawian trauma patients: a prospective observational cohort study.

Erica C Bjornstad, Zachary H Smith, William Muronya, Charles K Munthali, Amy K Mottl, Stephen W Marshall, Yvonne M Golightly, Keisha Gibson, Anthony Charles, Emily W Gower

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Erica C BjornstadDepartment of Pediatrics, Division of Nephrology, University of Alabama at Birmingham, 1600 7th Avenue South, Lowder 516, Birmingham, AL, 35233, USA. ebjornstad@uabmc.edu.
Zachary H SmithUniveristy of North Carolina Project Malawi, Lilongwe, Malawi.
William MuronyaDepartment of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
Charles K MunthaliDepartment of Medicine, Renal Unit, Kamuzu Central Hospital, Lilongwe, Malawi.
Amy K MottlDepartment of Medicine, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC, USA.
Stephen W MarshallUniversity of North Carolina Injury Prevention Research Center, Chapel Hill, USA.
Yvonne M GolightlyUniversity of North Carolina Injury Prevention Research Center, Chapel Hill, USA.
Keisha GibsonDepartment of Medicine, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC, USA.
Anthony CharlesDepartment of Surgery, University of North Carolina, Chapel Hill, NC, USA.
Emily W GowerDepartment of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill · USKamuzu Central Hospital · MWStanford University · USUniversity of Alabama at Birmingham · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTrauma is a common cause of acute kidney injury (AKI). Yet little data exist regarding trauma-related-AKI in low-resourced settings, where the majority of deaths from AKI and trauma occur. We prospectively evaluated epidemiology of AKI in hospitalized Malawian trauma patients.

methodsAKI was defined by creatinine-only Kidney Disease Improving Global Outcomes (KDIGO) criteria. Those with AKI were followed up 3-6 months later to determine persistent kidney abnormalities. We calculated univariate statistics with Wilcoxon rank sum tests, Fisher's exact, and chi-square tests to compare those with and without AKI. Multivariate log-risk regression modelling was used to determine risk ratios (RR) and 95% confidence intervals (CI) for AKI development.

resultsOf 223 participants, 14.4% (n = 32) developed AKI. Most patients were young (median age 32) males (n = 193, 86.5%) involved in road traffic injuries (n = 120, 53.8%). After adjusting for confounders, those with severe anemia during their admission were 1.4 times (RR 1.4, 95% CI 1.1-1.8) more likely to develop AKI than those without. Overall mortality was 7.6% (n = 17), and those who developed AKI were more likely to die than those who did not (18.8% vs 5.6%, p-value = 0.02). Almost half of those with AKI (n = 32) either died (n = 6) or had persistent kidney dysfunction at follow-up (n = 8).

conclusionIn one of the few African studies on trauma-related AKI, we found a high incidence of AKI (14.4%) in Malawian trauma patients with associated poor outcomes. Given AKI's association with increased mortality and potential ramifications on long-term morbidity, urgent attention is needed to improve AKI-related outcomes.

Indexed as

Acute Kidney InjuryAdultFemaleHumansMalawiMaleMiddle AgedProspective StudiesRisk AssessmentWounds and InjuriesAcute kidney injuryAfricaTrauma

Identifiers

PMID34711197
PMCPMC8552973
OpenAlexW3207986540

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.