Performance of a pre-procedural Mehran score to predict acute kidney injury after percutaneous coronary intervention
| Autor: | Michelle Nguyen, Sai Guduru, Shraddha Makadia, Faisal Rahim, Khalid Abusaada, Anamarys Blanco, Steven Quach |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Cardiac Catheterization Percutaneous medicine.medical_treatment Psychological intervention 030232 urology & nephrology Contrast Media 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Predictive Value of Tests Risk Factors Internal medicine Preoperative Care Kidney injury medicine Humans In patient Cardiac catheterization Aged Retrospective Studies business.industry Curve analysis Acute kidney injury Percutaneous coronary intervention General Medicine Acute Kidney Injury medicine.disease United States Nephrology Research Design Conventional PCI cardiovascular system Cardiology Female Complication business Kidney disease |
| Zdroj: | Nephrology (Carlton, Vic.)REFERENCES. 26(1) |
| ISSN: | 1440-1797 |
| Popis: | Aim Acute kidney injury (AKI) is a known complication of patients undergoing cardiac catheterization or percutaneous coronary interventions (PCI).The Mehran score was developed to identify patients at risk for AKI after cardiac catheterization or PCI, but its use of contrast volume as part of the score calculation limits its application prior to the procedure. In this study, we evaluated the utility of a modified Mehran score that utilizes only pre-procedural data by excluding contrast volume. Methods This was done in a retrospective fashion using data from patients who received PCI at our institution between July 2015 and December 2017 by evaluating the discriminative ability of the scoring systems for predicting outcomes through a receiver-operator characteristic curve analysis. Results One thousand five hundred and seven patients were included in the study. A total of 70 (4.6%) patients developed AKI. The removal of contrast volume from the Mehran score resulted in a small loss of discrimination with AUROC 0.73 vs 0.74, P = .01 for the pre-procedural Mehran and the original Mehran, respectively. When compared to the original score, the pre-procedural Mehran score had a four-category net discrimination index (NRI) of -0.10 and an integrated discrimination index (IDI) for of -0.12. Conclusion Despite a small loss in discrimination, there was no difference in the four-category net discrimination index between the two scores. The pre-procedural modified Mehran score is a useful clinical predictor of the risk of AKI in patients undergoing PCI. |
| Databáze: | OpenAIRE |
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