Development of a risk prediction score for acute kidney injury in critically-ill septic Filipino patients admitted in perpetual succour hospital
- Author:
Jane Lou E. Gargaritano
1
;
Joel John C. Mejos
1
;
Jewelyn M. Torrevillas
1
;
Giovanni A. Vista
1
;
Grecia Darunday
1
;
Eratosthenes S. Polito
1
Author Information
- Publication Type:Journal Article
- Keywords: Risk prediction score; Critically-ill patients
- MeSH: Acute Kidney Injury; Sepsis
- From: Philippine Journal of Internal Medicine 2023;61(4):201-209
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Acute kidney injury (AKI) is a lethal complication of critical illness characterized by the rapid loss of the
kidney's excretory function encountered in 50% of intensive care unit (ICU) admissions. Its impact on the outcome of
critically ill patients makes AKI a significant cause of morbidity and mortality.
Objectives:To develop and validate an acute kidney injury risk prediction score based on routinely available variables and common laboratories of admitted critically-ill septic Filipino patients.
Methods:This is a prospective cohort study conducted in a tertiary hospital in Cebu from February to September 2020. The data of 2545 patients were identified by chart review but only 607 patients with a quick Sepsis Organ Failure Assessment Score (qSOFA) score of >2 were included in the pre-screening. After stratified sampling, a total of 198 septic ICU patients were enrolled. Demographic profile, laboratory results and outcome data were collated. Variables were screened then stepwise forward elimination was done to identify the significant predictors. An AKI risk score model was developed with binomial regression analysis by identifying independent prognostic factors. The diagnostic ability of the model was determined by the Area under the Receiver Operating Characteristics (AuROC).
Results:AKI developed in 155 (78%) patients. The significant predictors for Acute Kidney Injury were age, hypertension, atherosclerotic cardiovascular disease, weight, white blood count, creatinine, and BUN. An AKI prediction model with a cut off score of 161.9 was made with a fair diagnostic ability for predicting AKI at 0.79 based on AuROC.
Conclusion:The developed risk prediction tool using routinely available variables is found to be fairly accurate to predict the development of AKI among critically ill septic patients. - Full text:pjim 210.pdf
