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Ika Puspitasari
LPPM - Universitas Jenderal Soedirman
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Therapeutic Outcomes Associated with Augmented Renal Clearance in Trauma Patients of the ICU at UGM Academic Hospital Utami, Annafi' Nanda Rohmah; Puspitasari, Ika; Andayani, Tri Murti
Academic Hospital Journal Vol 8, No 1 (2026)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v8i1.107202

Abstract

Background: Augmented Renal Clearance (ARC) occurs in intensive care units (ICUs) and results in increased drug clearance in critically ill patients. Trauma patients have a twofold higher risk of ARC. ARC can increase the risk of subtherapeutic drug dosing and therapeutic failure. This study aims to determine the characteristics of trauma patients with and without ARC and to investigate the association between ARC and therapeutic outcomes, including length of stay and clinical outcomes, in trauma patients admitted to the ICU at UGM Academic Hospital.Method: This study is an analytical observational study with a retrospective cohort design. The population in this study consists of adult patients diagnosed with trauma in the ICU at UGM Academic Hospital during the period from January 2021 - April 2024 who met the inclusion and exclusion criteria. Descriptive analysis was used to examine the characteristics of trauma patients in the ICU, with results presented in tables as percentages and mean values. An independent t-test was used to determine the difference in length of stay (LOS) between patients with and without ARC. The Chi-Square test was conducted to assess the association between ARC and clinical outcomes.Result:  The study population comprised 35 trauma patients in the ARC group and 49 in the non-ARC group. Both groups were predominantly male, with the mean age of trauma patients with ARC being younger (34.49 ± 13.38 years). ARC was characterised by lower serum creatinine levels and higher creatinine clearance. Trauma patients with ARC had a higher mean APACHE II score (9.69 ± 6.88) but a lower mean CCI score (0.54 ± 0.74). Trauma patients with ARC showed lower mean initial and final GCS scores (11.23 ± 4.12 and 11.63 ± 5.12, respectively). The mean leukocyte count in the ARC group was higher (16.57 ± 6.45 × 10³/µL), and the group had a higher infection rate (51.4%, n = 18). The mean LOS for trauma patients with ARC was longer (11.77 ± 15.35 days), but did not differ significantly from that of patients without ARC (p = 0.055). The number of trauma patients with ARC who did not show clinical improvement was significantly higher (28.6%, n = 10; p = 0.005).Conclusion: The mean LOS of trauma patients with ARC is longer, showing a tendency towards significance. ARC is associated with worse clinical outcomes in trauma patients in the ICU, as demonstrated by poor clinical outcomes in 10 patients.
Co-Authors Abdoellah, Siti Asfijah Abdul Gofir Achmad, Bayu Fandi Agil Novianto, Agil Agung Endro Nugroho Akhmad Kharis Nugroho Al-Muzzaki, Rizqi Hariyono Alchusnah, Retno Hayati Alexxander Alexxander, Alexxander Ali Djamhuri Amalia, Dita Ambar Yunita Nugraheni Amboro, Wisnu Andaru Dahesihdewi Annisa Oktafianti Nurlatifah, Annisa Oktafianti Arief Budiyanto Arief Nurrochmad Arifin, Shokhibul Arifin, Shokibul Asrori, A Astuti, Rini Budi Bakhruddin, Muhammad Bambang Sigit Riyanto Chairani, Farahdina Chandra Wahyu Purnomo Chandra, Lukman Ade Chusna, Nurul Darwito, Darwito Dibtyanusa, Ajib Djoko Wahyono Endang Lukitaningsih Ernawati, Hafifah Esti Dyah Utami Estiningsih, Daru Farisa Luthfiana Fatiha, Muvina Rizkia Fauziyah, Jihan Firmansyah, Moch Fikry Hafizah, Ilmi Nur Haryono, Eko Anwar Hemi Sinorita Hera Nirwati Heri Mulyanto, Heri HIDAYAT, MOCH CHARIS I Dewa Putu Pramantara Ida Safitri Laksanawati Ilham Perdana Ilmi, Miftakhun Nafidatul Indra Saputra Ismail, Asrul Khairunnisa, Dini Kumara, Intan Fatah Kurniawati, Fivy Kurniawaty, Yenni Dwi Kusharwanti, AM Wara Kusmantoro Edy S Lestari, Ayu Eka M. Yogi Riyantama Isjoni Maftuhah, Rifa’atul Mahmud Mahmud Marsila, Ulfi Ana Mika Tri Kumala Swandari, Mika Tri Kumala Mufida, Arizzatul Aulia Mulyani, Lili Nadiya, Salsabila Putri Nanang Munif Yasin Nastiti, Nindita Sari Nathania, Caroline Evanthe Naurah Alifah Rahmah Niken Puspitasari Nisa, Solikhatun Nunuk Aries Nurulita Nunung Yuniarti Nur Azza, Kamala Kan Nurul Hikmah Oktariyanto, Efel Erlambang Pratama, Alief Indra Pratiwi, Restu Dwi Probosuseno Probosuseno, Probosuseno Putri, Mukarromah Dita Rahmah, Naurah Alifah Rahmantika, Fitri Rizaldy Pinzon Rizka Humardewayanti Asdie Rochman, Zakki Tifani Ibadu Roni, Faishol Roostika, Raden Roro Ratna Rukmono Siswishanto Sarastuti, Dewi Sari Dewiyani, Sari Sarjito - Solekah, Putri Nur Sri Watini Sudar, Hasdiana Sugiarto S Sugiyarto, Okky Puspitasari Sumarningsih, Pebriati Suryani, Aliyatul Ilmi Susatyo Yuwono Susi Ari Kristina Susianti, Noor Alia Sutono Sutono Suwito, Darwito Tambun, Sabrina Handayani Thulus Hidayat, Thulus Titik Nuryastuti Titik Rahayu Tomo, Wahyu Kartiko Tri Hartati, Tri Tri Murti Andayani Tri Yanto Triswandari, Retno Utami, Annafi' Nanda Rohmah Wahyuntari, Evi Wardoyo, Eko Yanuar, Wihda Yunita Widyastuti Yusmiyati, Yusmiyati