Model of Rahmanian et al for Predicting Renal Failure After Cardiac Surgery That Requires Dialysis

Description

Rahmanian et al developed a model for predicting postoperative renal failure after cardiac surgery that requires dialsysis. This can help to identify a patient who may benefit from a change in management or more aggressive care. The authors are from University Hospital Cologne.

Patient selection: cardiac surgery

Parameters for multivariate regression analsyis:

(1) pulmonary hypertension

(2) preoperative serum creatinine in mg/dL

(3) cardiopulmonary bypass time (CPB) in minutes

(4) peripheral vascular disease

(5) recent myocardial infarction (within past 21 days)

(6) atrial fibrillation

(7) age in years

(8) NYHA class of heart failure

(9) diabetes mellitus

Parameter	Finding	Points
pulmonary hypertension	no	0
	yes	2.1
preoperative creatinine	<= 2 mg/dL	0
	> 2 mg/dL	1.5
bypass time	<= 120 minutes	0
	> 120 minutes	1.4
peripheral vascular disease	no	0
	yes	1.1
recent AMI	no	0
	yes	1.1
atrial fibrillation	no	0
	yes	1
age in years	<= 75 years	0
	> 75 years	0..9
NHYA	NYHA IV	0.9
	other	0
diabetes mellitus	no	0
	yes	0.7

X =

= SUM(points for all 9 parameters) - 3.1

probability of renal failure requiring dialysis =

= 1 / (1 + EXP((-1) *X))

Performance:

• The area under the ROC curve was 0.83 in the derivation set and 0.85 in the validation cohort.

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Model of Rahmanian et al for Predicting Renal Failure After Cardiac Surgery That Requires Dialysis

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