Simplified Clinical Risk Score to Predict Acute Kidney Injury After Aortic Surgery
- Authors
- Kim, WH[Kim, Won Ho]; Lee, SM[Lee, Sangmin M.]; Choi, JW[Choi, Ji Won]; Kim, EH[Kim, Eun Hee]; Lee, JH[Lee, Jong Hwan]; Jung, JW[Jung, Jae Woong]; Ahn, JH[Ahn, Joong Hyun]; Sung, KI[Sung, Ki Ick]; Kim, CS[Kim, Chung Su]; Cho, HS[Cho, Hyun Sung]
- Issue Date
- Dec-2013
- Publisher
- W B SAUNDERS CO-ELSEVIER INC
- Keywords
- acute kidney injury; thoracic aortic aneurysm; aortic dissection; risk factor
- Citation
- JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, v.27, no.6, pp.1158 - 1166
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
- Volume
- 27
- Number
- 6
- Start Page
- 1158
- End Page
- 1166
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/58322
- DOI
- 10.1053/j.jvca.2013.04.007
- ISSN
- 1053-0770
- 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 beta-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 (Cl): 0.69 to 0.79], which was similar to that in the validation cohort: 0.74 (95% Cl: 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. (C) 2013 Elsevier Inc. All rights reserved.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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