Ang et al reported the Acute Kidney Injury Risk Score (AKI-RiSc) to help to identify a patient in the Emergency Department at increased risk for acute kidney injury. Acute kidney injury is important to identify since it can negatively impact the patient. The authors are from the National University of Singapore, Duke University, Singapore Health Services, and Singapore General Hospital.
Patient selection: adult > 18 years admitted through the Emergency Department
Outcome: acute kidney injury of any stage within 7 days of admission
Parameters:
(1) serum creatinine in µmol/L
(2) serum bicarbonate in mmol/L
(3) heart rate in beats per minute
(4) systolic blood pressure in mm Hg
(5) diastolic blood pressure in mm Hg
(6) age of the patient in years
Parameter
Findiing
Points
serum creatinine
< 100 µmol/L
0
100 to 149 µmol/L
2
150 to 249 µmol/L
5
>= 250 µmol/L
7
serum bicarbonate
>= 20 mmol/L
0
< 20 mmol/L
1
heart rate
< 100 beats per minute
0
100 to 119 beats per minute
2
>= 120 beats per minute
3
systolic blood pressure
< 150 mm Hg
0
>= 150 mm Hg
1
diastolic blood pressure
< 90 mm Hg
0
>= 90 mm Hg
1
age in years
< 50 years
0
>= 50 years
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• A score >= 4 identifies a patient at increased risk for acute kidney injury with a sensitivity of 0.83 and specificity of 0.47.
Performance:
• The area under the ROC curve is 0.73.
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