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Risk Models of Tsai et al for Acute Kidney Injury Following Percutaneous Coronary Intervention (PCI): Model for Acute Kidney Injury (AKI) Requiring Dialysis

Description

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) heart failure in the prior 2 weeks

(2) GFR in mL per min

(3) diabetes mellitus

(4) coronary artery disease

(5) prior cardiac arrest

 

Parameter

Finding

Points

heart failure

no

0

 

yes

2

GFR

none (>= 60)

0

 

mild (45 to 59.5)

1

 

moderate (30 to 44.9)

3

 

severe (< 30)

5

diabetes

no

0

 

yes

1

coronary artery disease

no

0

 

unstable angina

1

 

NSTEMI

1

 

STEMI

2

prior cardiac arrest

no

0

 

yes

3

 

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 13

• The higher the score the greater the risk.

 

Score

Risk of AKI

0

0.03%

1

0.05%

2

0.09%

3

0.15%

4

0.27%

5

0.48%

6

0.84%

7

1.5%

8

2.6%

9

4.4%

10

7.6%

11

12.6%

12

20.3%

13

31%

 

Performance:

• The area under the ROC curve is 0.89.


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