Jiang et al developed 3 equations for evaluating a patient undergoing cardiac surgery. One used preoperative variables to identify a patient at risk for acute kidney injury (AKI). The authors are from Zhongshan Hospital and Shanghai Medical College in China.
Patient selection: cardiac surgery, not on renal replacement therapy
Outcome: acute kidney injury (serum creatinine > 2 mg/dL if baseline < 1.5 mg/dL; serum creatinine > 1.5 * (baseline) if baseline creatinine 1.5 to 3.0 mg/dL).
Parameters:
(1) gender
(2) age in years
(3) kidney disease
(4) NYHA class
(5) history of previous cardiac surgery
|
Parameter |
Finding |
Points |
|
gender |
female |
0 |
|
|
male |
1 |
|
age |
<= 40 years of age |
0 |
|
|
41 to 60 years |
1 |
|
|
61 to 80 years |
2 |
|
|
>= 81 years |
3 |
|
kidney disease |
none |
0 |
|
|
present without renal replacement |
1 |
|
NYHA class |
1 or 2 |
0 |
|
|
3 or 4 |
1 |
|
previous cardiac surgery |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk of acute kidney injury.
|
Total Score |
Points |
|
0 or 1 |
low |
|
2 or 3 |
medium |
|
4 to 7 |
high |
Performance:
• The area under the ROC curve was 0.74.
Specialty: Nephrology, Clinical Laboratory
