ABSTRACTS from 16th International COnference on ... - CRRT Online

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
53. A New Clinical Score to Predict
Acute Kidney Injury After
Cardiac Surgery in Chinese
Elderly Patients
Penghua Hu, Xinling Liang, Yuanhan
Chen, Ruizhao Li, Zhilian Li, Fen Jiang,
Wei Shi
Division of Nephrology, Guangdong
General Hospital, Guangdong Academy
of Medical Sciences, Guangzhou,
Guangdong,510080,China
Objective: To develop and validate a
risk score to predict acute kidney injury
(AKI) after cardiac surgery in Chinese
elderly patients. Methods: A
consecutive sample of 848 elderly
patients(age≥60 years old) who
underwent cardiac surgery with
cardiopulmonary bypass in the
Guangdong general hospital between
January 1, 2005 and July 31, 2010 was
evaluated. The clinical outcome was
AKI according to the serum creatinine
criteria of the RIFLE classification
during the first 7 days postoperatively.
Patients were excluded if they had an
end stage renal disease, or experienced
renal replacement therapy. Those who
had missing data were also excluded. In
randomly selected 682 patients of the
total cohorts, multivariate logistic
regression analysis was used to develop
a new prediction score based on clinical
characteristics and perioperative
variables of patients. The new score was
validated on the remaining patients.
Result: The incidence of AKI in the
derivation cohort which consisted of 682
patients was 62.3% (n=425), while in the
test cohort which consisted of 166
patients was 59.6% (n=99). Eight
variables were included in the predictive
index. Those variables in the new score
that an estimated glomerular filtration
rate less than 60 ml/min, male ,
hypertension, chronic heart failure New
York Heart Association above stage 2,
perioperative red blood cell transfusions
above 625 ml were assigned 2 points,
respectively. Cardiopulmonary bypass
time above 113 minutes and duration of
ventilator-assisted respiration during
postoperative above 24 hours were
assigned 3 points, respectively; other
component was assigned 1 point:
previous cardiac surgery. The patients
with risk score≤4 in derivation, the risk
of AKI was 26.0%; comparatively, the
risk was 92.6% among patients with risk
score≥13. The area under the receiver
operating characteristic curve, judging
the discrimination of the score, was
0.798 (95%CI 0.764 to 0.832) in the
derivation, which in the validation set
was 0.804 (95%CI 0.739 to 0.870). The
calibration of the score assessed using
the Hosmer-Lemeshow statistic in the
derivation and validation were 0.478,
0.224, respectively.
Conclusion: A new score based on
Chinese information was valid and
accurate in predicting AKI after cardiac
surgery in elderly patients. This score
may allow prevention of post-operative
AKI and early institution of therapeutic
interventions to attenuate the impact of
AKI on the prognosis of cardiac surgery
patients.
54. The Impact of Acute Kidney
Injury on In-Hospital Morbidity
and Mortality Among Patients
With and Without Baseline
Chronic Kidney Disease
Mira T Keddis, Sahil Khanna, Qi Qian
Mayo Clinic, Rochester, MN, USA
Background: Acute kidney injury (AKI)
is a well-recognized risk for chronic
kidney disease (CKD) and in-hospital
mortality. The effect of AKI on inhospital
morbidity and mortality among
164