Validating a scoring tool to predict acute kidney injury (AKI) following cardiac surgery

Canadian Journal of Kidney Health and Disease
Brian WongBhanu Prasad

Abstract

Acute kidney injury (AKI) after cardiac surgery is associated with an increased risk of mortality. Preoperative risk scores can identify patients at risk for AKI and facilitate preventive strategies. Currently, validated risk scores are used to predict AKI requiring dialysis (AKI-D); less is known about whether these tools predict less severe forms of AKI. To evaluate the Cleveland Clinic scoring tool in predicting both AKI-D and less severe stages of AKI in patients after cardiac surgery in a Canadian tertiary care center. Retrospective case-control study. Regina Qu'Appelle Health Region (RQHR) from 2007 to 2011. Patients who underwent cardiac surgery and developed postoperative kidney injury (n = 2316). Data on risk factors for AKI and outcomes of cardiac surgery were collected from a retrospective chart review. The primary outcome was AKI, defined as Stage 1 (increase in serum creatinine 1.5-1.9 X baseline within 5 days), Stage 2 (increase 2.0-2.9 X baseline), or Stage 3 (increase 3.0 X baseline or more OR initiation of dialysis during hospital stay). We assessed the performance of a modified version of the Cleveland Clinic tool using receiver operating curve analyses. The incidence of AKI was 6.1% (Stage 1), 2.6% (Stage 2),...Continue Reading

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Methods Mentioned

BETA
coronary artery bypass

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