Validation of the STARZ neonatal acute kidney injury risk stratification score

• Published in: Pediatric nephrology (Berlin, West) West), 2022-08, Vol.37 (8), p.1923-1932
• Main Authors: Sethi, Sidharth Kumar, Raina, Rupesh, Rana, Abhyuday, Agrawal, Gopal, Tibrewal, Abhishek, Bajaj, Naveen, Gupta, Naveen Parkash, Mirgunde, Shishir, Sahoo, Jagdish, Balachandran, Binesh, Afzal, Kamran, Shrivastava, Anubha, Bagla, Jyoti, Krishnegowda, Sushma, Konapur, Ananth, Soni, Kritika, Sharma, Divya, Khooblall, Amrit, Khooblall, Prajit, Bunchman, Timothy, Wazir, Sanjay
• Format: Article
• Language: English
• Subjects: Health care; Intensive care units; Kidneys; Medicine; Medicine & Public Health; Neonates; Nephrology; Newborn babies; Original Article; Pediatrics; Risk factors; Urology
• ISSN: 0931-041X; 1432-198X
• DOI: 10.1007/s00467-021-05369-1

Background Neonatal acute kidney injury (AKI) is common in neonatal intensive care units (NICU) and leads to worse outcomes. Stratifying neonates into an “at risk” category allows health care providers to objectively recognize opportunities for improvements in quality of care. Methods The “Neonatal AKI Risk Prediction Scoring” was devised as the “STARZ [Sethi, Tibrewal, Agrawal, Raina, waZir]” Score. The STARZ score was derived from our prior multicentre study analysing risk factors for AKI in neonates admitted to the NICU. This tool includes 10 variables with a total score ranging from 0 to 100 and a cut-off score of 31.5. In the present study, the scoring model has been validated in our multicentre cohort of 744 neonates. Results In the validation cohort, this scoring model had sensitivity of 82.1%, specificity 91.7%, positive predictive value 81.2%, negative predictive value 92.2% and accuracy 88.8%. Based on the STARZ cut-off score of ≥ 31.5, an area under the receiver operating characteristic (ROC) curve was observed to be 0.932 (95% CI, 0.910–0.954; p