Del Carpio Jacqueline, Marco Maria Paz, Martin Maria Luisa, Craver Lourdes, Jatem Elias, Gonzalez Jorge, Chang Pamela, Ibarz Mercedes, Pico Silvia, Falcon Gloria, Canales Marina, Huertas Elisard, Romero Iñaki, Nieto Nacho, Segarra Alfons
Department of Nephrology, Arnau de Vilanova University Hospital, Lleida, Spain.
Institut de Recerca Biomèdica, Lleida, Spain.
Clin Kidney J. 2021 Mar 26;14(11):2377-2382. doi: 10.1093/ckj/sfab068. eCollection 2021 Nov.
The Madrid Acute Kidney Injury Prediction Score (MAKIPS) is a recently described tool capable of performing automatic calculations of the risk of hospital-acquired acute kidney injury (HA-AKI) using data from from electronic clinical records that could be easily implemented in clinical practice. However, to date, it has not been externally validated. The aim of our study was to perform an external validation of the MAKIPS in a hospital with different characteristics and variable case mix.
This external validation cohort study of the MAKIPS was conducted in patients admitted to a single tertiary hospital between April 2018 and September 2019. Performance was assessed by discrimination using the area under the receiver operating characteristics curve and calibration plots.
A total of 5.3% of the external validation cohort had HA-AKI. When compared with the MAKIPS cohort, the validation cohort showed a higher percentage of men as well as a higher prevalence of diabetes, hypertension, cardiovascular disease, cerebrovascular disease, anaemia, congestive heart failure, chronic pulmonary disease, connective tissue diseases and renal disease, whereas the prevalence of peptic ulcer disease, liver disease, malignancy, metastatic solid tumours and acquired immune deficiency syndrome was significantly lower. In the validation cohort, the MAKIPS showed an area under the curve of 0.798 (95% confidence interval 0.788-0.809). Calibration plots showed that there was a tendency for the MAKIPS to overestimate the risk of HA-AKI at probability rates ˂0.19 and to underestimate at probability rates between 0.22 and 0.67.
The MAKIPS can be a useful tool, using data that are easily obtainable from electronic records, to predict the risk of HA-AKI in hospitals with different case mix characteristics.
马德里急性肾损伤预测评分（MAKIPS）是一种最近描述的工具，能够使用电子临床记录中的数据自动计算医院获得性急性肾损伤（HA-AKI）的风险，且可轻松应用于临床实践。然而，迄今为止，它尚未经过外部验证。我们研究的目的是在一家具有不同特征和病例组合的医院对MAKIPS进行外部验证。
这项对MAKIPS进行外部验证的队列研究在2018年4月至2019年9月期间入住一家三级医院的患者中进行。通过使用受试者操作特征曲线下面积和校准图进行鉴别来评估性能。
外部验证队列中共有5.3%的患者发生HA-AKI。与MAKIPS队列相比，验证队列中男性比例更高，糖尿病、高血压、心血管疾病、脑血管疾病、贫血、充血性心力衰竭、慢性肺病、结缔组织病和肾病的患病率也更高，而消化性溃疡病、肝病、恶性肿瘤、转移性实体瘤和获得性免疫缺陷综合征的患病率则显著较低。在验证队列中，MAKIPS的曲线下面积为0.798（95%置信区间0.788-0.809）。校准图显示，MAKIPS在概率率＜0.19时倾向于高估HA-AKI的风险，在概率率介于0.22和0.67之间时倾向于低估风险。
MAKIPS可以成为一种有用的工具，利用从电子记录中容易获得的数据，预测具有不同病例组合特征的医院中HA-AKI的风险。
