Jiang et al developed 3 equations for evaluating a patient undergoing cardiac surgery. One used variables at the time of 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) NYHA class
(5) history of previous cardiac surgery
(6) combined surgery (valve and CABG)
(7) red blood cell transfusion
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 |
combined surgery |
no |
0 |
|
yes |
1 |
red blood cell transfusion |
|
<units> |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8 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 0.75.
Specialty: Nephrology, Clinical Laboratory