Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients
Abstract Background Acute kidney injury (AKI) is a major complication of acute myocardial infarction(AMI), which can significantly increase mortality. This study is to analyze the related risk factors and establish a prediction score of acute kidney injury in order to take early measurement for prev...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-019-1379-x |
| _version_ | 1818161704254570496 |
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| author | Feng-bo Xu Hong Cheng Tong Yue Nan Ye He-jia Zhang Yi-pu Chen |
| author_facet | Feng-bo Xu Hong Cheng Tong Yue Nan Ye He-jia Zhang Yi-pu Chen |
| author_sort | Feng-bo Xu |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI) is a major complication of acute myocardial infarction(AMI), which can significantly increase mortality. This study is to analyze the related risk factors and establish a prediction score of acute kidney injury in order to take early measurement for prevention. Methods The medical records of 6014 hospitalized patients with AMI in Beijing Anzhen Hospital from January 2010 to December 2016 were retrospectively analyzed. These patients were randomly assigned into two cohorts: one was for the derivation of prediction score (n = 4252) and another for validation (n = 1762). The criterion for AKI was defined as an increase in serum creatinine of ≥ 0.3 mg/dL or ≥ 50% from baseline within 48 h. On the basis of odds ratio obtained from multivariate logistic regression analysis, a prediction score of acute kidney injury after AMI was built up. Results In this prediction score, risk score 1 point included hypertension history, heart rate > 100 bpm on admission, peak serum troponin I ≥ 100 μg/L, and time from admission to coronary reperfusion > 120 min; risks score 2 points included Killip classification ≥ class 3 on admission; and maximum dosage of intravenous furosemide ≥ 60 mg/d; risks score 3 points only included shock during hospitalization. In addition, when baseline estimated glomerular filtration rate (eGFR) was less than 90 ml/min·1.73 m2, every 10 ml/min·1.73 m2 reduction of eGFR increased risk score 1 point. Youden index showed that the best cut-off value for prediction of AKI was 3 points with a sensitivity of 71.1% and specificity 74.2%. The datasets of derivation and validation both displayed adequate discrimination (an area under the ROC curve, 0.79 and 0.81, respectively) and satisfactory calibration (Hosmer–Lemeshow statistic test, P = 0.63 and P = 0.60, respectively). Conclusions In conclusion, a prediction score for AKI secondary to AMI in Chinese patients was established, which may help to prevent AKI early. |
| first_indexed | 2024-12-11T16:22:00Z |
| format | Article |
| id | doaj.art-a2ba87f07a8f41dea78e7dd025244b5a |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-11T16:22:00Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-a2ba87f07a8f41dea78e7dd025244b5a2022-12-22T00:58:49ZengBMCBMC Nephrology1471-23692019-05-0120111110.1186/s12882-019-1379-xDerivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patientsFeng-bo Xu0Hong Cheng1Tong Yue2Nan Ye3He-jia Zhang4Yi-pu Chen5Department of Nephrology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Nephrology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Nephrology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Nephrology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Nephrology, Beijing Anzhen Hospital, Capital Medical UniversityDepartment of Nephrology, Beijing Anzhen Hospital, Capital Medical UniversityAbstract Background Acute kidney injury (AKI) is a major complication of acute myocardial infarction(AMI), which can significantly increase mortality. This study is to analyze the related risk factors and establish a prediction score of acute kidney injury in order to take early measurement for prevention. Methods The medical records of 6014 hospitalized patients with AMI in Beijing Anzhen Hospital from January 2010 to December 2016 were retrospectively analyzed. These patients were randomly assigned into two cohorts: one was for the derivation of prediction score (n = 4252) and another for validation (n = 1762). The criterion for AKI was defined as an increase in serum creatinine of ≥ 0.3 mg/dL or ≥ 50% from baseline within 48 h. On the basis of odds ratio obtained from multivariate logistic regression analysis, a prediction score of acute kidney injury after AMI was built up. Results In this prediction score, risk score 1 point included hypertension history, heart rate > 100 bpm on admission, peak serum troponin I ≥ 100 μg/L, and time from admission to coronary reperfusion > 120 min; risks score 2 points included Killip classification ≥ class 3 on admission; and maximum dosage of intravenous furosemide ≥ 60 mg/d; risks score 3 points only included shock during hospitalization. In addition, when baseline estimated glomerular filtration rate (eGFR) was less than 90 ml/min·1.73 m2, every 10 ml/min·1.73 m2 reduction of eGFR increased risk score 1 point. Youden index showed that the best cut-off value for prediction of AKI was 3 points with a sensitivity of 71.1% and specificity 74.2%. The datasets of derivation and validation both displayed adequate discrimination (an area under the ROC curve, 0.79 and 0.81, respectively) and satisfactory calibration (Hosmer–Lemeshow statistic test, P = 0.63 and P = 0.60, respectively). Conclusions In conclusion, a prediction score for AKI secondary to AMI in Chinese patients was established, which may help to prevent AKI early.http://link.springer.com/article/10.1186/s12882-019-1379-xAcute kidney injuryAcute myocardial infarctionPrediction score |
| spellingShingle | Feng-bo Xu Hong Cheng Tong Yue Nan Ye He-jia Zhang Yi-pu Chen Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients BMC Nephrology Acute kidney injury Acute myocardial infarction Prediction score |
| title | Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients |
| title_full | Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients |
| title_fullStr | Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients |
| title_full_unstemmed | Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients |
| title_short | Derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in Chinese patients |
| title_sort | derivation and validation of a prediction score for acute kidney injury secondary to acute myocardial infarction in chinese patients |
| topic | Acute kidney injury Acute myocardial infarction Prediction score |
| url | http://link.springer.com/article/10.1186/s12882-019-1379-x |
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