Acute Renal Failure
Conditions
Keywords
Development, Pre- and intra-operative predictors, Acute renal failure, Liver Surgery, Prediction score, Validation, Clinical consequences, Decision curve analysis, predictors of acute renal failure after liver resection
Brief summary
Post-operative acute renal failure is a severe post-operative complication and is associated with high mortality. The enhanced prediction score, including pre-as well as intra-operative predictors accurately predicted ARF following hepatic surgery. This prediction score allows early identification of patients at high risk of ARF and may support decision-making for protective kidney treatment.
Detailed description
To enhance and validate an already pre-existing score accurately predicting post-operative acute renal failure (ARF) after hepatic surgery We will enhance a pre-existing score predicting ARF based on pre-operative as well as intra-operative predictors. Development process: we will identify the strongest predictors of ARF in a multivariable logistic regression model followed by a stepwise backward logistic regression analysis and bootstrapping. Validation process: we will perform an internal validation by calibrating the prediction model as well as by k-fold cross validation (c statistics) and bootstrapping. Additionally, we will calculate the discrimination by the area under the curve (AUC). Decision curve analysis: Furthermore we will perform a decision curve analysis to evaluate the clinical consequences of both prediction scores whether a patient with increased ARF risk would post-operative benefit of a treatment on the ICU.
Interventions
None listed
Sponsors
University of Zurich
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* \> 18 years * scheduled for liver surgery * benign as well as malignant diseases
Exclusion criteria
* liver trauma * incomplete data sets * pre-operative chronic renal failure requiring hemodialysis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Development of an enhanced prediction score for ARF | within 48 hours post-operative | Development of an enhanced but still simple and easy applicable score based on pre- and extended by intra-operative risk factors to predict postoperative ARF in patients scheduled for liver resection |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Decision curve analysis | within 48 hours post-operative | Describing a decision making model by performing a decision curve analysis for clinical consequences of the enhanced prediction score and comparing it with the pre-operative prediction score |
| internal validation of the enhanced prediction score | within 48 hours post-operative | internal Validation: discrimination, calibration, k-fold cross validation and bootstrapping |
Countries
Switzerland
Outcome results
None listed