Nephroprotection in Severe Trauma Patients With Kidney Stress

Proportion of patients with AKI within 7 days of ICU admission

AKI will be defined according to KDIGO criteria, either by a drop in urine output (oliguria \< 0.5ml/kg/h for 6h) and/or a rise in serum creatinine (1.5x baseline or increase of 26.5 µmol/l).

Time frame: During 7 days from ICU admission

Proportion of patients with severe AKI within 3 days of ICU admission

Severe AKI is defined as AKI stage 2 or 3 according to KDIGO criteria

Time frame: During 3 days from ICU admission

Proportion of patients with severe AKI within 7 days of ICU admission

Severe AKI is defined as AKI stage 2 or 3 according to KDIGO criteria

Time frame: During 7 days from ICU admission

Proportion of patients with MAKE (MAjor Adverse Kidney Event) 28

MAKE 28 is defined by the occurrence of one event among (1) death before day 28 after ICU admission, (2) requirement of renal replacement therapy on day 28 or (3) incomplete renal recovery on day 28.

Time frame: At 28 days after ICU admission

Proportion of patients with a complication among cardiovascular and hemodynamic complications; septic complications; hemorrhagic complications within 7 days after ICU admission

Cardiovascular or hemodynamic complications include ventricular cardiac rhythm disorders, cardiogenic acute pulmonary edema and poorly controlled arterial hypertension \[MAP (Mean Arterial Pressure) \> 120 mmHg for 4 hours\]. Septic complications correspond to sepsis defined by the association of an infection and an increase in SOFA \>=2. Hemorrhagic complications are defined by the number of packed red blood cells (RBCs) used.

Time frame: During 7 days after ICU admission.

Proportion of patients with at least one episode of dysglycemia within 3 days after ICU admission

Episodes of dysglycemia are defined as hypoglycemia (\<4mmol/l) or hyperglycemia (\>12mmol/l).

Time frame: During 3 days after ICU admission.

ICU and hospital length-of-stay

Total number of days spent in critical care (intensive care, continuous care) and in the initial hospital

Time frame: During 28 days from ICU admission

Identification of risk factors for AKI in trauma patients using clinical and laboratory parameters

Known and novel risk factors for AKI in trauma patients will be evaluated using clinical variables (e.g., age, comorbidities, injury severity scores), hemodynamic parameters (e.g., MAP, lactate), and biomarkers of kidney function (e.g., CPK, TIMP-2/IGFBP-7)

Time frame: During 7 days from ICU admission

Incidence of AKI in trauma patients within 3 days of ICU admission based on KDIGO Criteria

The incidence of all stages and severe AKI in trauma patients at risk will be assessed based on the KDIGO criteria

Time frame: During 3 days after ICU admission

Characterization of AKI episodes phenotype in trauma patients using KDIGO criteria

Acute Kidney Injury episodes will be characterized based on a combination of factors including : * Time to AKI onset: defined as the time (in hours) from ICU admission to the diagnosis of AKI * Diagnostic criteria: whether the AKI is diagnosed based on serum creatinine or urine output changes * Severity: the highest KDIGO stage (1, 2, or 3) reached during the episode * Duration: transient (\<48h) or persistent (≥48h) AKI.

Time frame: During 7 days from ICU admission

Proportion of patients receiving the nephroprotection bundle-of-care in its entirety, by component, and by practice.

The entirety of the nephroprotection bundle-of-care is defined by the combination of at least one practice from each component: medication, hemodynamics, rhabdomyolysis, monitoring, glycemia

Time frame: During 3 days after ICU admission

Cost-effectiveness incremental ratio of the nephroprotection bundle-of-care compared with standard-of-care at 7 days after ICU admission.

The incremental cost-effectiveness ratio will be expressed as the additional cost per AKI avoided.

Time frame: At 7 days after ICU admission

Cost-effectiveness incremental ratio of the nephroprotection bundle-of-care compared with standard-of-care at 28 days after ICU admission.

The incremental cost-effectiveness ratio will be expressed as the additional cost per AKI avoided.

Time frame: At 28 days after ICU admission

Average costs of initial hospital stay for each group

Time frame: During 28 days after ICU admission