Format

Send to

Choose Destination
See comment in PubMed Commons below
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.

Author information

  • 1Department of Anesthesiology and Pain Medicine.

Abstract

OBJECTIVE:

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.

DESIGN:

Retrospective and observational.

SETTING:

Single large university hospital.

PARTICIPANTS:

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

MAIN RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

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

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk