Predictive value of venous excess ultrasound grading system in acute kidney injury of hospitalized patients with multiple trauma

Jiang Sumei; Chen Yuanyuan; Que Xianqin

doi:10.3969/j.issn.1002-1949.2024.09.005

Abstract：Objective To investigate the predictive value of venous excess ultrasound(VExUS)grading system in acute kidney injury(AKI)of hospitalized patients with multiple trauma.Methods A total of 162 patients with multiple trauma admitted to Lishui Central Hospital from November 2020 to December 2023 were selected as the research objects.According to whether AKI occurred during hospitalization,they were divided into AKI group(n=61)and non-AKI group(n=101).The clinical data and VExUS scores were collected.Logistic regression analysis was used to explore the risk factors of AKI,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of VExUS score.At the same time,35 patients with multiple trauma complicated with AKI who met the inclusion and exclusion criteria in Lishui Central Hospital from January to March 2024 were selected as the verification objects,and the ROC curve was drawn to verify the value of VExUS score in predicting AKI in the patients with multiple trauma.Results Multivariate Logistic regression analysis showed that serum creatinine(SCr),procalcitonin(PCT),Cystatin C(Cys-C),C-reactive protein(CRP)and VExUS score were risk factors for AKI in the patients with multiple trauma(P＜0.05).The results of ROC curve analysis showed that the areas under ROC curve(AUC)of SCr,PCT,Cys-C,CRP and VExUS scores in predicting AKI in the patients with multiple trauma were 0.636(95％CI0.516-0.758,P=0.023),0.742(95％CI0.633-0.850,P＜0.001),0.628(95％CI 0.521-0.735,P=0.022),0.705(95％CI 0.601-0.808,P=0.001)and 0.793(95％CI0.715-0.871,P＜0.001),respectively.Among them,the predicted ROC of VExUS score was the highest,and the optimal cut-off value was 2 points.At this time,the sensitivity was 81.97％and the specificity was 61.66％.The results of the validated ROC curve showed that the VExUS score still had a good predictive value for AKI in the patients with multiple trauma,and the AUC was 0.740(95％CI 0.648-0.831).Conclusion The VExUS score has a good predictive value for AKI in the patients with multiple trauma.