Risk Factors for the Development of Acute Kidney Injury Among Burn Patients in Intensive Care Units and Dedicated Burn Units: A Systematised Review

Abstract

Abstract Background: Patients with burns who are admitted to intensive care units (ICUs) and burn units commonly suffer from acute kidney injury (AKI). AKIs in burn patients are linked to a higher risk of mortality and increased hospital stay. In order to improve the outcomes for patients with burns covering 10% or more of their total body surface area (TBSA), it is important to ascertain the risk factors for the development of AKI. Aim: This paper aimed to identify the risk factors associated with the development of AKI in burn patients admitted to ICUs or burn units. Methods: A systemised review was conducted by searching PubMed, Ovid Medline and Google Scholar. Relevant articles written within the last 5 years were included. The studies were retained if they were written in English, identified risk factors for AKI development and recruited adult burn patients with burns covering a TBSA ≥ 10% who were admitted to a burn unit or ICU. Results: The database search produced 1,644 publications. Five of these publications were considered relevant after meeting the inclusion criteria. All included studies were critically appraised using the Critical Appraisal Skills Programme tool. All of the reviewed studies were observational, single-centre cohort studies that reported a significant relationship between percent of TBSA burned and AKI development. Conclusion: The risk factors for AKI development in the burn population are percent of TBSA burned, rhabdomyolysis, undetectable haptoglobin, sepsis, age and cardiac comorbidities.