Development and Validation of a Web-based Prediction Model for Acute Kidney Injury after surgery
| Autor: | Jingjing Zhang, Sang Hoon Woo, Lily Ackermann, Jillian Zavodnick, Scott W. Cowan, Omar H. Maarouf |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Creatinine Receiver operating characteristic business.industry medicine.medical_treatment Acute kidney injury Retrospective cohort study medicine.disease Surgery chemistry.chemical_compound chemistry Heart failure Cohort medicine Renal replacement therapy business Dialysis |
| DOI: | 10.1101/2020.07.03.20145094 |
| Popis: | Background and objectivesAcute kidney injury after surgery is associated with high mortality and morbidity. The purpose of this study is to develop and validate a risk prediction tool for the occurrence of postoperative acute kidney injury requiring renal replacement therapy.Design, setting, participants, measurementsThis retrospective cohort study had 2,299,502 surgical patients over 2015-2017 from the American College of Surgeons National Surgical Quality Improvement Program Database (ACS-NSQIP). Eleven predictors were selected for the predictive model: age, history of congestive heart failure, diabetes, ascites, emergency surgery, preoperative serum creatinine, hematocrit, sodium, preoperative sepsis, preoperative acute renal failure and surgery type. The predictive model was trained using 2015-2016 data (n=1,487,724) and further tested using 2017 data (n=811,778). A risk model was developed using multivariate logistic regression and machine learning methods.Main outcomesThe primary outcome was postoperative 30-day acute kidney injury requiring renal replacement therapy(AKI-D)ResultsThe unadjusted 30-day postoperative mortality rate associated with AKI-D was 37.5%. The renal risk prediction model had high AUC (area under the receiver operating characteristic curve, training cohort: 0.89, test cohort: 0.90) for postoperative AKI-D.ConclusionsThis model provides a clinically useful bedside predictive tool for postoperative acute kidney injury requiring dialysis. |
| Databáze: | OpenAIRE |
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