CHIEH-KAI CHANChi, Chun-YiChun-YiChiTAI-SHUAN LAITAO-MIN HUANGNAI-KUAN CHOUHuang, Yi-PingYi-PingHuangProwle, John R.John R.ProwleVIN-CENT WUYUNG-MING CHEN2020-12-242020-12-242020-122045-2322https://www.scopus.com/inward/record.uri?eid=2-s2.0-85096594262&doi=10.1038%2fs41598-020-77556-3&partnerID=40&md5=9c7665ce4491165aa4fcde3c97c46723https://scholars.lib.ntu.edu.tw/handle/123456789/531528Acute kidney injury (AKI) is a frequent complication of traumatic injury; however, long-term outcomes such as mortality and end-stage kidney disease (ESKD) have been rarely reported in this important patient population. We compared the long-term outcome of vehicle-traumatic and non-traumatic AKI requiring renal replacement therapy (AKI-RRT). This nationwide cohort study used data from the Taiwan National Health Insurance Research Database. Vehicle-trauma patients who were suffered from vehicle accidents developing AKI-RRT during hospitalization were identified, and matching non-traumatic AKI-RRT patients were identified between 2000 and 2010. The incidences of ESKD, 30-day, and long-term mortality were evaluated, and clinical and demographic associations with these outcomes were identified using Cox proportional hazards regression models. 546 vehicle-traumatic AKI-RRT patients, median age 47.6?years (interquartile range: 29.0–64.3) and 76.4% male, were identified. Compared to non-traumatic AKI-RRT, vehicle-traumatic AKI-RRT patients had longer length of stay in hospital [median (IQR):15 (5–34) days vs. 6 (3–11) days; p < 0.001). After propensity matching with non-traumatic AKI-RRT cases with similar demographic and clinical characteristics. Vehicle-traumatic AKI-RRT patients had lower rates of long-term mortality (adjusted hazard ratio (HR), 0.473; 95% CI, 0.392–0.571; p < 0.001), but similar rates of ESKD (HR, 1.166; 95% CI, 0.829–1.638; p = 0.377) and short-term risk of death (HR, 1.134; 95% CI, 0.894–1.438; p = 0.301) as non-traumatic AKI-RRT patients. In competing risk models that focused on ESKD, vehicle-traumatic AKI-RRT patients were associated with lower ESKD rates (HR, 0.552; 95% CI, 0.325–0.937; p = 0.028) than non-traumatic AKI-RRT patients. Despite severe injuries, vehicle-traumatic AKI-RRT patients had better long-term survival than non-traumatic AKI-RRT patients, but a similar risk of ESKD. Our results provide a better understanding of long-term outcomes after vehicle-traumatic AKI-RRT. ? 2020, The Author(s).en[SDGs]SDG3acute kidney failure; adult; cohort analysis; female; human; incidence; injury; intensive care unit; male; middle aged; mortality; procedures; proportional hazards model; renal replacement therapy; retrospective study; Taiwan; Acute Kidney Injury; Adult; Cohort Studies; Female; Humans; Incidence; Intensive Care Units; Male; Middle Aged; Proportional Hazards Models; Renal Replacement Therapy; Retrospective Studies; Taiwan; Wounds and Injuriesjournal article10.1038/s41598-020-77556-3332396572-s2.0-85096594262