Older people admitted to hospital after a fall are also at higher risk of developing acute kidney problems, research shows.
Acute kidney injury (AKI) is one of the most common complications during hospitalisation and is associated with significant worsening of clinical outcomes including inpatient mortality, extended hospital stay, and development of chronic kidney disease (CKD).
Now colleagues from Northern Care Alliance, working with researchers from the universities of Manchester and Southampton, have carried out the first comprehensive evaluation of AKI risk in older trauma patients.
Their analysis of 2,211 ward-level hospital trauma admissions at Salford Royal Hospital from 2014 to 2022 showed those aged 65 and over were more likely to develop AKI than younger people (12 per cent versus two per cent).
In older people, those who’d suffered trauma to their hips or legs had the highest incidence of AKI. Those who had existing heart failure were also more likely to be affected by AKI.
The full results have been published in the journal PLOS One.
Evidence gap
Co-lead author Advanced Clinical Practitioner Elizabeth Finnimore (pictured), who now works at Fairfield General Hospital, explained the importance of the study. She said: “Falls are the most common type of accidents in people aged 65 and older – in 2023/24 there were more than 219,000 emergency hospital admissions in England related to falls in this age group.
“We already have guidelines for evaluating risk of AKI for inpatients, which highlight the importance of monitoring high-risk patients – older people, those with cardiovascular problems and some acute issues such as sepsis.
“But the guidelines are generalised and may not adequately consider the risk of AKI in trauma. Older people are largely absent in past studies of this area, so there is an evidence gap.
“We know AKI has been estimated to develop in up to half of severely injured patients and is a leading cause of organ failure and consequently death so it’s crucial that trauma units are aware of the risks and also of the different risks for older people.”
* Omar Kiwan, Elizabeth Finnimore, Benjamin James, Paul Robinson, Mohammed Al-Kalbani, Becky Bonfield, Darren Green: Risk factors for and outcomes of acute kidney injury in ward-based hospital trauma admissions: A retrospective cohort analysis (PLOS One).