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J Cardiothorac Vasc Anesth. 2013 Dec;27(6):1158-66. doi: 10.1053/j.jvca.2013.04.007. Epub 2013 Sep 17.

Simplified clinical risk score to predict acute kidney injury after aortic surgery.

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  • 1Department of Anesthesiology and Pain Medicine.



The authors identified risk factors for acute kidney injury (AKI) defined by risk, injury, failure, loss, end-stage (RIFLE) criteria after aortic surgery with cardiopulmonary bypass and constructed a simplified risk score for the prediction of AKI.


Retrospective and observational.


Single large university hospital.


Patients (737) who underwent aortic surgery with cardiopulmonary bypass between 1997 and 2010.


Multivariate logistic regression analysis was used to evaluate risk factors. A scoring model was developed in a randomly selected derivation cohort (n = 417), and was validated on the remaining patients. The scoring model was developed with a score based on regression β-coefficient, and was compared with previous indices as measured by the area under the receiver operating characteristic curve (AUC). The incidence of AKI was 29.0%, and 5.8% required renal replacement therapy. Independent risk factors for AKI were age older than 60 years, preoperative glomerular filtration rate <60 mL/min/1.73 m(2), left ventricular ejection fraction <55%, operation time >7 hours, intraoperative urine output <0.5 mL/kg/h, and intraoperative furosemide use. The authors made a score by weighting them at 1 point each. The risk score was valid in predicting AKI, and the AUC was 0.74 [95% confidence interval (CI): 0.69 to 0.79], which was similar to that in the validation cohort: 0.74 (95% CI: 0.69 to 0.80; p = 0.97). The risk-scoring model showed a better performance compared with previously reported indices.


The model would provide a simplified clinical score stratifying the risk of postoperative AKI in patients undergoing aortic surgery.

Copyright © 2013 Elsevier Inc. All rights reserved.


acute kidney injury; aortic dissection; risk factor; thoracic aortic aneurysm

[PubMed - indexed for MEDLINE]
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