Aortic Surgery, Postoperative Acute Kidney Injury
Conditions
Keywords
aortic surgery, acute kidney injury, gray zone approach
Brief summary
Acute kidney injury after cardiac surgery has been reported to increase morbidity and mortality. Several risk scoring models for prediction of aortic kidney injury after cardiac surgery have been developed. However, predictive accuracy of these models is stil unclear. The aim of this study is to evaluate the accuracy of four pre-existing prediction models using a gray zone approach in patients who underwent aortic surgery in our institution.
Detailed description
Acute kidney injury after cardiac surgery has been reported to increase morbidity and mortality. Several risk scoring models for prediction of aortic kidney injury after cardiac surgery have been developed. However, predictive accuracy of these models is stil unclear. The aim of this study is to evaluate the accuracy of four pre-existing prediction models (AKICS, Wijeysundera, Mehta, and Thakar model)using a gray zone approach in patients who underwent aortic surgery in our institution. Based on receiver operating characteristic (ROC) curve analysis, we will construct a gray zone using the cut-off values with a sensitivity of \< 90%, and a specificity of \< 90% (diagnostic tolerance of 10%).
Interventions
PROCEDUREelective or emergency aortic surgery (including ascending, arch, descending thoracic aorta)
Sponsors
Samsung Medical Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Those who underwent elective or emergency aortic surgery in Samsung Medical Center during between 2004 and 2010.
Exclusion criteria
* missing laboratory data * preoperative hemodialysis * death during or within 48 hours after surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| presence of acute kidney injury | within 48 hour after aortic surgery | 1. abrupt (within 48 hours) reduction in kidney function currently defined as 2. absolute increase in serum creatinine of more than or equal to 0.3 mg/dl (≥ 26.4 μmol/l), 3. a percentage increase in serum creatinine of more than or equal to 50% (1.5-fold from baseline), or 4. a reduction in urine output (documented oliguria of less than 0.5 ml/kg per hour for more than six hours) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gray zone range of each risk scoring model | within 48 hours | Thresholds with as a sensitivity of \< 90% and a specificity of \< 90%. |
| Number of patients in the gray zone | within 48 hours after aortic surgery | Number of patients in the gray zone in each risk scoring model |
Countries
South Korea
Outcome results
None listed