Ahmed et al reported a score for predicting severe kidney injury in an adult trauma patient. This can help to identify a patient who may require more aggressive management. The authors are from Jersey Sore University and VA Columbia Health Care System in South Carolina.
Patient: acute trauma, adult < 90 years of age
Parameters:
(1) sex
(2) race
(3) systolic blood pressure in mm Hg
(4) diabetes
(5) hypertension
(6) congestive heart failure
(7) age in years
(8) Injury Severity Score (ISS)
Parameter
Finding
Points
sex
female
0
male
5
race
White
0
non-White
3
systolic blood pressure
>= 90 mm Hg
0
< 90 mm Hg
11
diabetes
no
0
yes
5
hypertension
no
0
yes
4
congestive heart failure
no
0
yes
8
age in years
< 45 years
0
45 to 54 years
3
55 to 74 years
5
75 to 89 years
7
ISS
< 15
0
15 to 24
7
25 to 34
12
35 to 44
19
45 to 75
21
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 64
• The risk is low for scores <= 10 but then rises exponentially.
• A score >= 40 tends to overpredict the risk of AKI.
Performance:
• The area under the ROC curve is 0.75.
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