A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study.
Acute kidney injury (AKI) is a serious post-surgery complication; however, few preoperative risk models for AKI have been developed for hypertensive patients undergoing general surgery. Thus, in this study involving a large Chinese cohort, we developed and validated a risk model for surgery-related...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5089779?pdf=render |
| _version_ | 1811208814689517568 |
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| author | Xing Liu Yongkai Ye Qi Mi Wei Huang Ting He Pin Huang Nana Xu Qiaoyu Wu Anli Wang Ying Li Hong Yuan |
| author_facet | Xing Liu Yongkai Ye Qi Mi Wei Huang Ting He Pin Huang Nana Xu Qiaoyu Wu Anli Wang Ying Li Hong Yuan |
| author_sort | Xing Liu |
| collection | DOAJ |
| description | Acute kidney injury (AKI) is a serious post-surgery complication; however, few preoperative risk models for AKI have been developed for hypertensive patients undergoing general surgery. Thus, in this study involving a large Chinese cohort, we developed and validated a risk model for surgery-related AKI using preoperative risk factors.This retrospective cohort study included 24,451 hypertensive patients aged ≥18 years who underwent general surgery between 2007 and 2015. The endpoints for AKI classification utilized by the KDIGO (Kidney Disease: Improving Global Outcomes) system were assessed. The most discriminative predictor was selected using Fisher scores and was subsequently used to construct a stepwise multivariate logistic regression model, whose performance was evaluated via comparisons with models used in other published works using the net reclassification index (NRI) and integrated discrimination improvement (IDI) index.Surgery-related AKI developed in 1994 hospitalized patients (8.2%). The predictors identified by our Xiang-ya Model were age, gender, eGFR, NLR, pulmonary infection, prothrombin time, thrombin time, hemoglobin, uric acid, serum potassium, serum albumin, total cholesterol, and aspartate amino transferase. The area under the receiver-operating characteristic curve (AUC) for the validation set and cross validation set were 0.87 (95% CI 0.86-0.89) and (0.89; 95% CI 0.88-0.90), respectively, and was therefore similar to the AUC for the training set (0.89; 95% CI 0.88-0.90). The optimal cutoff value was 0.09. Our model outperformed that developed by Kate et al., which exhibited an NRI of 31.38% (95% CI 25.7%-37.1%) and an IDI of 8% (95% CI 5.52%-10.50%) for patients who underwent cardiac surgery (n = 2101).We developed an AKI risk model based on preoperative risk factors and biomarkers that demonstrated good performance when predicting events in a large cohort of hypertensive patients who underwent general surgery. |
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| format | Article |
| id | doaj.art-99141aa3ca09407dbc598b05673aa613 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T04:27:54Z |
| publishDate | 2016-01-01 |
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| series | PLoS ONE |
| spelling | doaj.art-99141aa3ca09407dbc598b05673aa6132022-12-22T03:48:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011111e016528010.1371/journal.pone.0165280A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study.Xing LiuYongkai YeQi MiWei HuangTing HePin HuangNana XuQiaoyu WuAnli WangYing LiHong YuanAcute kidney injury (AKI) is a serious post-surgery complication; however, few preoperative risk models for AKI have been developed for hypertensive patients undergoing general surgery. Thus, in this study involving a large Chinese cohort, we developed and validated a risk model for surgery-related AKI using preoperative risk factors.This retrospective cohort study included 24,451 hypertensive patients aged ≥18 years who underwent general surgery between 2007 and 2015. The endpoints for AKI classification utilized by the KDIGO (Kidney Disease: Improving Global Outcomes) system were assessed. The most discriminative predictor was selected using Fisher scores and was subsequently used to construct a stepwise multivariate logistic regression model, whose performance was evaluated via comparisons with models used in other published works using the net reclassification index (NRI) and integrated discrimination improvement (IDI) index.Surgery-related AKI developed in 1994 hospitalized patients (8.2%). The predictors identified by our Xiang-ya Model were age, gender, eGFR, NLR, pulmonary infection, prothrombin time, thrombin time, hemoglobin, uric acid, serum potassium, serum albumin, total cholesterol, and aspartate amino transferase. The area under the receiver-operating characteristic curve (AUC) for the validation set and cross validation set were 0.87 (95% CI 0.86-0.89) and (0.89; 95% CI 0.88-0.90), respectively, and was therefore similar to the AUC for the training set (0.89; 95% CI 0.88-0.90). The optimal cutoff value was 0.09. Our model outperformed that developed by Kate et al., which exhibited an NRI of 31.38% (95% CI 25.7%-37.1%) and an IDI of 8% (95% CI 5.52%-10.50%) for patients who underwent cardiac surgery (n = 2101).We developed an AKI risk model based on preoperative risk factors and biomarkers that demonstrated good performance when predicting events in a large cohort of hypertensive patients who underwent general surgery.http://europepmc.org/articles/PMC5089779?pdf=render |
| spellingShingle | Xing Liu Yongkai Ye Qi Mi Wei Huang Ting He Pin Huang Nana Xu Qiaoyu Wu Anli Wang Ying Li Hong Yuan A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study. PLoS ONE |
| title | A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study. |
| title_full | A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study. |
| title_fullStr | A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study. |
| title_full_unstemmed | A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study. |
| title_short | A Predictive Model for Assessing Surgery-Related Acute Kidney Injury Risk in Hypertensive Patients: A Retrospective Cohort Study. |
| title_sort | predictive model for assessing surgery related acute kidney injury risk in hypertensive patients a retrospective cohort study |
| url | http://europepmc.org/articles/PMC5089779?pdf=render |
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