Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study

BackgroundThis study sought to develop and validate a dynamic nomogram chart to assess the risk of acute kidney injury (AKI) in patients with acute ischemic stroke (AIS).MethodsThese data were drawn from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which collects 47 clin...

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Main Authors: Ganggui Zhu, Zaixiang Fu, Taian Jin, Xiaohui Xu, Jie Wei, Lingxin Cai, Wenhua Yu
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-09-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2022.987684/full
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author Ganggui Zhu
Zaixiang Fu
Taian Jin
Xiaohui Xu
Jie Wei
Lingxin Cai
Wenhua Yu
author_facet Ganggui Zhu
Zaixiang Fu
Taian Jin
Xiaohui Xu
Jie Wei
Lingxin Cai
Wenhua Yu
author_sort Ganggui Zhu
collection DOAJ
description BackgroundThis study sought to develop and validate a dynamic nomogram chart to assess the risk of acute kidney injury (AKI) in patients with acute ischemic stroke (AIS).MethodsThese data were drawn from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which collects 47 clinical indicators of patients after admission to the hospital. The primary outcome indicator was the occurrence of AKI within 48 h of intensive care unit (ICU) admission. Independent risk factors for AKI were screened from the training set using univariate and multifactorial logistic regression analyses. Multiple logistic regression models were developed, and nomograms were plotted and validated in an internal validation set. Based on the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to estimate the performance of this nomogram.ResultsNomogram indicators include blood urea nitrogen (BUN), creatinine, red blood cell distribution width (RDW), heart rate (HR), Oxford Acute Severity of Illness Score (OASIS), the history of congestive heart failure (CHF), the use of vancomycin, contrast agent, and mannitol. The predictive model displayed well discrimination with the area under the ROC curve values of 0.8529 and 0.8598 for the training set and the validator, respectively. Calibration curves revealed favorable concordance between the actual and predicted incidence of AKI (p > 0.05). DCA indicates the excellent net clinical benefit of nomogram in predicting AKI.ConclusionIn summary, we explored the incidence of AKI in patients with AIS during ICU stay and developed a predictive model to help clinical decision-making.
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spelling doaj.art-d874b99fad5d463aa8df5663f468e79d2022-12-22T03:19:35ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.987684987684Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective studyGanggui Zhu0Zaixiang Fu1Taian Jin2Xiaohui Xu3Jie Wei4Lingxin Cai5Wenhua Yu6Department of Neurosurgery, Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurosurgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaDepartment of Neurosurgery, Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, ChinaBackgroundThis study sought to develop and validate a dynamic nomogram chart to assess the risk of acute kidney injury (AKI) in patients with acute ischemic stroke (AIS).MethodsThese data were drawn from the Medical Information Mart for Intensive Care III (MIMIC-III) database, which collects 47 clinical indicators of patients after admission to the hospital. The primary outcome indicator was the occurrence of AKI within 48 h of intensive care unit (ICU) admission. Independent risk factors for AKI were screened from the training set using univariate and multifactorial logistic regression analyses. Multiple logistic regression models were developed, and nomograms were plotted and validated in an internal validation set. Based on the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) to estimate the performance of this nomogram.ResultsNomogram indicators include blood urea nitrogen (BUN), creatinine, red blood cell distribution width (RDW), heart rate (HR), Oxford Acute Severity of Illness Score (OASIS), the history of congestive heart failure (CHF), the use of vancomycin, contrast agent, and mannitol. The predictive model displayed well discrimination with the area under the ROC curve values of 0.8529 and 0.8598 for the training set and the validator, respectively. Calibration curves revealed favorable concordance between the actual and predicted incidence of AKI (p > 0.05). DCA indicates the excellent net clinical benefit of nomogram in predicting AKI.ConclusionIn summary, we explored the incidence of AKI in patients with AIS during ICU stay and developed a predictive model to help clinical decision-making.https://www.frontiersin.org/articles/10.3389/fneur.2022.987684/fullacute ischemic strokeacute kidney injurynomogramMIMIC-III databaseretrospective study
spellingShingle Ganggui Zhu
Zaixiang Fu
Taian Jin
Xiaohui Xu
Jie Wei
Lingxin Cai
Wenhua Yu
Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
Frontiers in Neurology
acute ischemic stroke
acute kidney injury
nomogram
MIMIC-III database
retrospective study
title Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
title_full Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
title_fullStr Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
title_full_unstemmed Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
title_short Dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke: A retrospective study
title_sort dynamic nomogram for predicting acute kidney injury in patients with acute ischemic stroke a retrospective study
topic acute ischemic stroke
acute kidney injury
nomogram
MIMIC-III database
retrospective study
url https://www.frontiersin.org/articles/10.3389/fneur.2022.987684/full
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