Jiang et al developed 3 equations for evaluating a patient undergoing cardiac surgery. One used variables at 24 hours after ICU admission 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) cardiopulmonary bypass (CPB)
(5) history of previous cardiac surgery
(6) combined surgery (valve and CABG)
(7) red blood cell transfusion
(8) low cardiac output syndrome (LCOS)
|
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 |
|
cardiopulmonary bypass |
no |
0 |
|
|
yes |
1 |
|
previous cardiac surgery |
no |
0 |
|
|
yes |
1 |
|
combined surgery |
no |
0 |
|
|
yes |
1 |
|
red blood cell transfusion |
|
<units> |
|
LCOS |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9 plus number of RBC untis transfused
• The higher the score the greater the risk of acute kidney injury.
|
Total Score |
Points |
|
0 or 4 |
low |
|
5 to 9 |
medium |
|
>= 10 |
high |
Performance:
• The area under the ROC curve was 0.82.
Specialty: Nephrology, Clinical Laboratory
