Computed tomography scans with intravenous contrast: low incidence of contrast-induced nephropathy in blunt trauma patients.

Background: Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of the blunt trauma patient; however, the risk for contrast-induced nephropathy (CIN) in these patients still remains unclear. The goal of this study was to describe the rate of CIN in blunt trauma patients at a Level 1 trauma center and identify the risk factors of developing CIN.

Methods: After internal review board approval, we reviewed our Level 1 trauma registry to identify blunt trauma patients admitted during a 1-year period. Chart review was used to identify patient demographics, creatinine levels, and vital signs. CIN was defined as an increase in creatinine by 0.5 mg/dL from admission after undergoing CT with IV contrast.

Results: Four percent of patients developed CIN during their admission following receipt of IV contrast for CT; 1% had continued renal impairment on discharge. No patients required dialysis during their admission. Diabetic patients had an increased rate of CIN, with 10% rate of CIN during admission and 4% at discharge. In multivariate analysis, only preexisting diabetes and Injury Severity Score (ISS) of greater than 25 were independently associated with risk for CIN.

Conclusion: The rate of CIN in trauma patients following CT scan with IV contrast is low. Diabetes and ISS were independent risk factors of development of CIN in trauma patients.

Level Of Evidence: Epidemiologic/prognostic study, level III.