External Validation for Acute Kidney Injury Severity Scores: A Multicenter Retrospective Study in 14 Japanese ICUs

American Journal of Nephrology
Tetsu OhnumaJSEPTIC (Japanese Society for Physicians and Trainees in Intensive Care) Clinical Trial Group

Abstract

Acute kidney injury (AKI) is associated with high mortality. Multiple AKI severity scores have been derived to predict patient outcome. We externally validated new AKI severity scores using the Japanese Society for Physicians and Trainees in Intensive Care (JSEPTIC) database. New AKI severity scores published in the 21st century (Mehta, Stuivenberg Hospital Acute Renal Failure (SHARF) II, Program to Improve Care in Acute Renal Disease (PICARD), Vellore and Demirjian), Liano, Simplified Acute Physiology Score (SAPS) II and lactate were compared using the JSEPTIC database that collected retrospectively 343 patients with AKI who required continuous renal replacement therapy (CRRT) in 14 intensive care units. Accuracy of the severity scores was assessed by the area under the receiver-operator characteristic curve (AUROC, discrimination) and Hosmer-Lemeshow test (H-L test, calibration). The median age was 69 years and 65.8% were male. The median SAPS II score was 53 and the hospital mortality was 58.6%. The AUROC curves revealed low discrimination ability of the new AKI severity scores (Mehta 0.65, SHARF II 0.64, PICARD 0.64, Vellore 0.64, Demirjian 0.69), similar to Liano 0.67, SAPS II 0.67 and lactate 0.64. The H-L test also demon...Continue Reading

Citations

Apr 27, 2016·Advances in Chronic Kidney Disease·Blaithin A McMahon, Jay L Koyner
Jan 11, 2019·BMJ : British Medical Journal·Jason T Poston, Jay L Koyner
Feb 14, 2018·Clinical Medicine : Journal of the Royal College of Physicians of London·Muhammad FaisalMohammed A Mohammed
Mar 30, 2016·Current Opinion in Nephrology and Hypertension·Harold M Szerlip, Lakhmir S Chawla
Apr 28, 2018·Critical Care : the Official Journal of the Critical Care Forum·Jian-Jhong WangKwan-Dun Wu

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