Abstract: SA-PO011

Prediction Model for AKI after Non-Cardiac Surgery

Session Information

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
Male2 points
Hypertension1 point
Cerebrovascular accident1 point
Thoracic surgery3 points
Abdominal surgery2 points
Pelvic surgery and replacement of major joints2 points
Emergency surgery2 points
Insulin2 points
Vasopressor1 point
Hct<401 point
BMI>231 point
eGFR<303 points
30 < eGFR < 601 point