@article {Pratte000672, author = {Ryan Pratt and Mete Erdogan and Robert Green and David Clark and Amanda Vinson and Karthik Tennankore}, title = {Outcomes of major trauma among patients with chronic kidney disease and receiving dialysis in Nova Scotia: a retrospective analysis}, volume = {6}, number = {1}, elocation-id = {e000672}, year = {2021}, doi = {10.1136/tsaco-2020-000672}, publisher = {BMJ Specialist Journals}, abstract = {Background The risk of death and complications after major trauma in patients with chronic kidney disease (CKD) is higher than in the general population, but whether this association holds true among Canadian trauma patients is unknown.Objectives To characterize patients with CKD/receiving dialysis within a regional major trauma cohort and compare their outcomes with patients without CKD.Methods All major traumas requiring hospitalization between 2006 and 2017 were identified from a provincial trauma registry in Nova Scotia, Canada. Trauma patients with stage >=3 CKD (estimated glomerular filtration rate \<60 mL/min/1.73 m2) or receiving dialysis were identified by cross-referencing two regional databases for nephrology clinics and dialysis treatments. The primary outcome was in-hospital mortality; secondary outcomes included hospital/intensive care unit (ICU) length of stay (LOS) and ventilator-days. Cox regression was used to adjust for the effects of patient characteristics on in-hospital mortality.Results In total, 6237 trauma patients were identified, of whom 4997 lived within the regional nephrology catchment area. CKD/dialysis trauma patients (n=101; 28 on dialysis) were older than patients without CKD (n=4896), with higher rates of hypertension, diabetes, and cardiovascular disease, and had increased risk of in-hospital mortality (31\% vs 11\%, p\<0.001). No differences were observed in injury severity, ICU LOS, or ventilator-days. After adjustment for age, sex, and injury severity, the HR for in-hospital mortality was 1.90 (95\% CI 1.33 to 2.70) for CKD/dialysis compared with patients without CKD.Conclusion Independent of injury severity, patients without CKD/dialysis have significantly increased risk of in-hospital mortality after major trauma.Data are available on reasonable request. Following closure of this study, deidentified study data were stored in a study folder with limited access on the Trauma Nova Scotia shared drive, with access subject to audit. All paper records are stored in a locked filing cabinet within the locked office of Dr Robert Green (Room 347, Bethune Building, VG Site, QEII Health Sciences Centre, Halifax, NS). Clinical data used in this study will remain in the MyNephrology and NSTR databases. At the end of a 7-year retention period, all paper documents will be shredded, and destruction of the electronic study files will be performed by Nova Scotia Health IT services.}, URL = {http://tsaco.smart01.highwire.org/content/6/1/e000672}, eprint = {http://tsaco.smart01.highwire.org/content/6/1/e000672.full.pdf}, journal = {Trauma Surgery \& Acute Care Open} }