Acute Kidney Injury Following Cardiac Surgery (AKICS) Score of Palomba et al for a Patient Undergoing Elective Cardiac Surgery

Description

Palomba et al reported the AKICS score for predicitng acute kidney injury after elective cardiac surgery. This can help to identify a patient who may benefit from alternative or more aggressive management. The authors are from the University of Sao Paulo in Brazil.

Patient selection: elective cardiac surgery

Parameters:

(1) type of cardiac surgery (CABG, valve or both)

(2) NYHA class for heart failure

(3) preoperative serum creatinine in mg/dL

(4) postoperative cardiac output

(5) age in years

(6) time on cardiopulmonary bypass (CPB) in minutes

(7) preoperative capillary glucose in mg/dL (presumably whole blood)

(8) central venous pressure (CVP) in cm water

Parameter	Finding	Points
type of cardiac surgery	CABG or valve	0
	combined	3.7
NYHA class	0 to 2	0
	3 or 4	3.2
preoperative creatinine	<= 1.2 mg/dL	0
	> 1.2 mg/dL	3.1
cardiac output postop	normal	0
	low (LVEF < 50%)	2.5
age in years	<= 65 years of age	0
	> 65 years of age	2.3
time on CPB	<= 120 minutes	0
	> 120 minutes	1.8
preoperative glucose	<= 140 mg/dL	0
	> 140 mg/dL	1.7
CVP	<= 14 cm water	0
	> 14 cm water	1.7

total score =

= SUM(points for all 8 parameters)

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the score the greater the risk for acute kidney injury.

Total Score	Percent AKI
<= 4	1.5%
4.1 to 8	4.3%
8.1 to 12	9%
12.1 to 16	22%
16.1 to 20	63%

Performance:

• The area under the ROC curve is 0.70.

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Acute Kidney Injury Following Cardiac Surgery (AKICS) Score of Palomba et al for a Patient Undergoing Elective Cardiac Surgery

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