Tsai Pei-Hsin, Wang Jun-Sing, Shen Ching-Hui
Department of Anesthesiology, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan.
J Clin Med. 2024 May 7;13(10):2740. doi: 10.3390/jcm13102740.
The incidence of postoperative acute kidney injury (AKI) is relatively high in some Asian regions. The objective of this study was to examine the performance of an AKI prediction model developed based on data from a White-dominant population in a retrospective Asian cohort of patients undergoing cardiovascular surgery. We retrospectively identified 549 patients who underwent elective major cardiovascular surgery (coronary artery bypass graft, valve surgery, and aorta surgery), and excluded those who underwent a percutaneous cardiovascular procedure. Patients with a baseline estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m were also excluded. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) definition. Performance of the prediction model for AKI was expressed as area under the receiver operating characteristic curve (AUC). The prediction model had a good predictive accuracy for postoperative AKI (all AUC > 0.92). The AUC of the prediction model in subgroups of age (<65 years and ≥65 years), sex (male and female), hypertension, and diabetes were all >0.85 (all values < 0.001). The model could be used to predict postoperative AKI in Asian patients undergoing cardiovascular surgery with a baseline eGFR ≥ 60 mL/min/1.73 m.
在一些亚洲地区，术后急性肾损伤（AKI）的发生率相对较高。本研究的目的是在一个以白人为主的人群数据基础上开发的AKI预测模型，在一个亚洲心血管手术患者回顾性队列中检验其性能。我们回顾性地确定了549例接受择期重大心血管手术（冠状动脉旁路移植术、瓣膜手术和主动脉手术）的患者，并排除了那些接受经皮心血管介入手术的患者。基线估计肾小球滤过率（eGFR）<60 mL/min/1.73 m²的患者也被排除。AKI根据《改善全球肾脏病预后组织（KDIGO）》的定义来确定。AKI预测模型的性能以受试者操作特征曲线（AUC）下面积表示。该预测模型对术后AKI具有良好的预测准确性（所有AUC>0.92）。预测模型在年龄（<65岁和≥65岁）、性别（男性和女性）、高血压和糖尿病亚组中的AUC均>0.85（所有P值<0.001）。该模型可用于预测基线eGFR≥60 mL/min/1.73 m²的亚洲心血管手术患者术后的AKI。
