Tsai et al evaluated patients for acute kidney injury following a percutaneous coronary intervention (PCI). One model predicts acute kidney injury (AKI) while a second predicts AKI requiring dialysis. The authors are from multiple institutions in the United States using the National Cardiovascular Data Registry Cath-PCI Registry.
Patient selection: status post percutaneous coronary intervention (PCI)
Outcome: acute kidney injury
Parameters:
(1) age in years
(2) heart failure within past 2 weeks
(3) GFR in mL per minute
(4) diabetes
(5) prior heart failure
(6) prior cerebrovascular disease (CVD)
(7) coronary artery disease
(8) prior cardiogenic shock
(9) prior cardiac arrest
(10) anemia
(11) intra-aortic balloon pump (IABP) before the procedure
|
Parameter |
Finding |
Points |
|
age in years |
< 50 |
0 |
|
|
50 to 59 |
2 |
|
|
60 to 69 |
3 |
|
|
70 to 79 |
6 |
|
|
80 to 89 |
8 |
|
|
>= 90 |
10 |
|
heart failure |
no |
0 |
|
|
yes |
11 |
|
GFR |
none (>= 60) |
0 |
|
|
mild (45 to 59.5) |
3 |
|
|
moderate (30 to 44.9) |
8 |
|
|
severe (< 30) |
18 |
|
diabetes |
no |
0 |
|
|
yes |
7 |
|
prior heart failure |
no |
0 |
|
|
yes |
4 |
|
prior CVD |
no |
0 |
|
|
yes |
4 |
|
coronary artery disease |
no |
0 |
|
|
unstable angina |
6 |
|
|
NSTEMI |
6 |
|
|
STEMI |
15 |
|
prior cardiogenic shock |
no |
0 |
|
|
yes |
16 |
|
prior cardiac arrest |
no |
0 |
|
|
yes |
8 |
|
anemia |
no |
0 |
|
|
yes |
10 |
|
IABP |
no |
0 |
|
|
yes |
11 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 114
• The higher the score the greater the risk of acute kidney injury.
|
Score |
Risk of AKI |
|
0 |
1.9% |
|
5 |
2.6% |
|
10 |
3.6% |
|
15 |
4.9% |
|
20 |
6.7% |
|
25 |
9.2% |
|
30 |
12.4% |
|
35 |
16.5% |
|
40 |
21.7% |
|
45 |
27.9% |
|
50 |
35.1% |
|
55 |
43% |
|
>= 60 |
51.4% |
This is approximated by an equation:
risk =
= (0.015928 * ((score)^2)) - (0.15217 * (score)) + 2.8703
Performance:
• The area under the ROC curve is 0.72.
Specialty: Hematology Oncology, Cardiology, Nephrology
