Abstract: SA-PO011
Prediction Model for AKI after Non-Cardiac Surgery
Session Information
- AKI Clinical: Epidemiology and Outcomes
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Acute Kidney Injury
- 003 AKI: Clinical and Translational
Authors
- Kokubu, Maiko, nara medical university, NARA, Japan
- Tagawa, Miho, nara medical university, NARA, Japan
- Hamano, Takayuki, Osaka University , Suita, Osaka, Japan
- Nishimoto, Masatoshi, Nara Medical University, Nara, Japan
- Matsui, Masaru, Nara Medical University, Kashihara, Japan
- Samejima, Ken-ichi, Nara Medical University, Kashihara, Japan
- Akai, Yasuhiro, Nara Medical University, Nara, Japan
- Saito, Yoshihiko, Nara Medical University, Nara, Japan
Background
There are many prediction models for AKI after cardiac surgery, but few reports exist for non-cardiac surgery.
Methods
This is a retrospective cohort study in adults who underwent non-cardiac surgery under general anesthesia from 2007-2010. We exclude patients who had preoperative dialysis, urologic, and obstetric surgery or did not have creatinine level preoperatively. Predictive variables were patients' demographics and characteristics of surgeries. Outcome variable was AKI within 1 week postoperatively according to the KDIGO criteria. The cohort was divided into derivation and validation cohorts (2:1). In derivation cohort, predictors of AKI were analyzed by multivariate logistic regression analysis and prediction model was created using regression coefficients. Validity of the model was tested in validation cohort using ROC curve and calibration slope.
Results
Among 2,912 patients in the derivation cohort, 172 (5.9%) patients developed AKI. Variables independently associated with AKI and points according to the model are shown (Table). In the validation cohort, AUC was 0.72 (0.67-0.77) and there was no significant difference in predicted and observed incidence (p=0.12) (Fig).
Conclusion
Our prediction model for AKI after non-cardiac surgery was well calibrated. The model needs to be validated in other cohorts.
Prediction model
| Male | 2 points |
| Hypertension | 1 point |
| Cerebrovascular accident | 1 point |
| Thoracic surgery | 3 points |
| Abdominal surgery | 2 points |
| Pelvic surgery and replacement of major joints | 2 points |
| Emergency surgery | 2 points |
| Insulin | 2 points |
| Vasopressor | 1 point |
| Hct<40 | 1 point |
| BMI>23 | 1 point |
| eGFR<30 | 3 points |
| 30 < eGFR < 60 | 1 point |