Mithiran et al developed a score for predicting acute kidney injury (AKI) following coronary artery bypass graft (CABG) surgery in an Asian patient. This can help to identify a patient who may benefit from a more aggressive management. The authors are from National University Health System in Singapore.
Patient selection: Asian undergoing CABG surgery
Outcome: acute kidney injury (AKI)
Parameters:
(1) eGFR in mL per minute per 1.73 square meters BSA
(2) aortic cross clamp time in minutes
(3) age in years
(4) left ventricular ejection fraction (LVEF) in percent
(5) cardiopulmonary bypass (CPB) time in minutes
(6) diabetes requiring insulin
|
Parameter |
Finding |
Points |
|
eGFR |
>= 60 |
0 |
|
|
< 60 |
5 |
|
aortic cross clamp time |
<= 100 minutes |
0 |
|
|
> 100 minutes |
2.5 |
|
age in years |
<= 60 years |
0 |
|
|
> 60 years |
2 |
|
LVEF |
>= 40% |
0 |
|
|
< 40% |
1.5 |
|
CPB time |
<= 140 minutes |
0 |
|
|
> 140 minutes |
1.5 |
|
diabetes requiring insulin |
no |
0 |
|
|
yes |
1.5 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• The higher the score the greater the risk for AKI.
|
Score |
AKI |
Renal Replacement Therapy or Dialysis |
|
<= 5.0 |
17% |
1% |
|
5.5 to 9.0 |
44% |
7% |
|
>= 9.5 |
77% |
15% |
Performance:
• The area under the ROC curve was 0.74.
Specialty: Nephrology, Clinical Laboratory
