Development and Validation of a Web-Based Prediction Model for AKI after Surgery

• Published in: Kidney360 2021-02, Vol.2 (2), p.215-223
• Main Authors: Woo, Sang H, Zavodnick, Jillian, Ackermann, Lily, Maarouf, Omar H, Zhang, Jingjing, Cowan, Scott W
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - diagnosis; Humans; Internet; Original Investigations; Postoperative Complications - diagnosis; Renal Dialysis; Retrospective Studies; Risk Assessment
• ISSN: 2641-7650; 2641-7650
• DOI: 10.34067/KID.0004732020

AKI after surgery is associated with high mortality and morbidity. The purpose of this study is to develop and validate a risk prediction tool for the occurrence of postoperative AKI requiring RRT (AKI-dialysis). This retrospective cohort study had 2,299,502 surgical patients over 2015-2017 from the American College of Surgeons National Surgical Quality Improvement Program Database (ACS NSQIP). Eleven predictors were selected for the predictive model: age, history of congestive heart failure, diabetes, ascites, emergency surgery, hypertension requiring medication, preoperative serum creatinine, hematocrit, sodium, preoperative sepsis, and surgery type. The predictive model was trained using 2015-2016 data ( =1,487,724) and further tested using 2017 data ( =811,778). A risk model was developed using multivariable logistic regression. AKI-dialysis occurred in 0.3% ( =6853) of patients. The unadjusted 30-day postoperative mortality rate associated with AKI-dialysis was 37.5%. The AKI risk prediction model had high area under the receiver operating characteristic curve (AUC; training cohort: 0.89, test cohort: 0.90) for postoperative AKI-dialysis. This model provides a clinically useful bedside predictive tool for postoperative AKI requiring dialysis.